STEP 7: Complete the procedure.
Instruct the patient to apply pressure to the venipuncture site while elevating
the extended arm for several minutes until the bleeding stops.
Figure 2-1h. Have the patient extend the arm and maintain light pressure on the site.
c. Considerations and Precautions Associated with Venipuncture.
(1) Behavioral problems may be encountered from some patients because of
anxiety. Remember that the patient is not as familiar with the procedure as you are. The
patient's apprehensions can be eased with a step-by-step explanation of what is going
on. Always talk in a calm and assuring tone of voice. Do not forget to be tactful.
Remember, treat the patient as you would want to be treated if you were at the other end
of the needle.
(2) If problems are encountered entering the vein or if blood is emptying out
of the vein into the tissue (hematoma), remove the tourniquet immediately. Then,
withdraw the needle, apply pressure to the site, and elevate the arm.
(3) A frequent side effect of phlebotomy is fainting (syncope). When
encountered with this situation, remove the tourniquet, withdraw the needle, apply
pressure, and lay the patient down. Then elevate the patient's feet, loosen clothing,
revive the patient with ammonia, and remove the patient from the view of other patients.
Do not assume a position that may be construed as a threat to the awakening patient.
Lastly, avoid comments that may be felt to be detrimental or insulting.
THE CAPILLARY PUNCTURE
When only a small amount of blood is required, a capillary puncture should be
performed. This is the simplest means of obtaining blood, but remember, this is still a
minor surgical procedure. Although there are several recommended anatomical sites for
the procedure, the most often used is the lateral aspect of the palmar surface of the ring
finger on the nondominant hand. This finger usually has the softest skin and puncturing