Difficulty: Easy

Average Score: 87%

When using a butterfly needle for venipuncture on dorsal hand veins, which of the following actions should the phlebotomist take?

Rationale

Hold the needle by the wings of the butterfly.

Using a butterfly needle, the phlebotomist should hold the needle by its wings to provide better control and stability during venipuncture, especially in smaller veins like those found in the dorsal hand. This technique minimizes movement and increases the likelihood of a successful blood draw.

A (Position the needle at a 45° angle to the skin.) YOUR ANSWER

While the angle of insertion is important, a butterfly needle is typically inserted at a lower angle, often around 10 to 15 degrees, to ensure proper access to smaller veins. Positioning it at a 45° angle may increase the risk of puncturing through the vein or causing unnecessary trauma.

C (Instruct the patient to hold the collection tubes.) YOUR ANSWER

The phlebotomist should maintain control over the collection process, including holding the tubes, to ensure proper technique and prevent contamination or accidents. Asking the patient to hold the tubes can lead to mishandling, which may compromise the sample or the procedure.

D (Apply the tourniquet at the antecubital area.) YOUR ANSWER

Applying the tourniquet at the antecubital area is not appropriate when accessing veins in the dorsal hand; instead, the tourniquet should be placed above the site of venipuncture. This helps engorge the veins in the hand without affecting those in the arm, thereby improving visibility and access.

Conclusion

In venipuncture using a butterfly needle, holding the needle by the wings is crucial for maintaining control and ensuring a successful draw, particularly in smaller veins like those in the dorsal hand. Incorrect techniques, such as inappropriate angles, patient involvement in holding tubes, or improper tourniquet placement, can compromise the procedure, highlighting the importance of adhering to established best practices in phlebotomy.

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