A child has a central venous access device for intravenous (IV) fluid administration. A blood sample is needed for a complete blood count, hemogram, and electrolytes. What is the appropriate procedure to implement for this blood sample?
a. Perform a new venipuncture to obtain the blood sample.
b. Interrupt the IV fluid and withdraw the blood sample needed.
c. Withdraw a blood sample equal to the amount of fluid in the device, discard, and then withdraw the sample needed.
d. Flush the line and central venous device with saline and then aspirate the required amount of blood for the sample.
ANS: C
The blood specimen obtained must reflect the appropriate hemodilution of the blood and electrolyte concentration. The nurse needs to withdraw the amount of fluid that is in the device and discard it. The next sample will come from the child's circulating blood. With a central venous device, the trauma of a separate venipuncture can be avoided. The blood sample will be diluted with either the IV fluid being administered or the saline.
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