GROUP 18 Assignment 1
MEMBERS
Eregae Lopeyok Charles
Brenda Karimi
Shirleen Muregi
Shadrack Eto
Ann Waithera
Akoyo Ridge
A. VENIPUNCTURE NURSING MANAGEMENT
Assessment
i. Assess the patient’s knowledge and understanding of the procedure.
ii. Review the patient’s medical history for conditions affecting
venipuncture, such as bleeding disorders (hemophilia) or use of
anticoagulants.
iii. Check for allergies to antiseptics or latex.
iv. Evaluate the patient’s hydration status, as dehydration can make
veins difficult to locate.
v. Identify an appropriate vein for venipuncture based on physical
examination such as visible, palpable veins.
vi. Assess for anxiety or fear related to needles or the procedure.
Diagnosis
1. Risk for injury related to improper venipuncture technique or bleeding.
2. Anxiety related to fear of the procedure or pain.
3. Impaired skin integrity related to venipuncture.
4. Risk for infection related to invasive procedure.
Planning
Goals
i. Ensure successful venipuncture with minimal discomfort.
ii. Prevent complications, such as infection, hematoma, or nerve injury.
iii. Reduce patient anxiety through education and reassurance.
iv. Maintain sterile technique to promote patient safety.
Preparation
i. Gather all necessary equipment (sterile needles, syringes,
tourniquet, alcohol swabs, gloves, collection tubes, gauze, and
bandages).
ii. Plan to use the least invasive site possible while ensuring
accessibility.
iii. Verify patient identity and confirm the purpose of the venipuncture
eg. diagnostic testing, blood donation.
iv. Select an appropriate site for the procedure and ensure proper
positioning of the patient.
Implementation
Pre-Procedure:
I. Explain the procedure to the patient to reduce anxiety and
gain cooperation.
II. Perform hand hygiene and don gloves.
III. Position the patient comfortably, ensuring that the arm is
supported and the vein is accessible.
IV. Apply a tourniquet 3–4 inches above the selected site and
palpate the vein to confirm suitability.
During the Procedure:
V. Clean the venipuncture site with antiseptic in a circular
motion, allowing it to dry.
VI. Insert the needle at a 15-30° angle with the bevel facing up.
VII. Observe for blood return in the needle hub or syringe,
indicating correct placement.
VIII. Collect the necessary blood samples in the appropriate
sequence (order of draw).
Post-Procedure:
IX. Remove the needle and immediately apply pressure with
gauze to the puncture site.
X. Secure the site with a clean bandage after hemostasis is
achieved.
XI. Dispose of used needles and other sharps in a puncture-proof
container.
XII. Document the procedure, including the site used, number of
attempts, and any patient reactions.
Evaluation
i. Inspect for signs of bleeding, hematoma formation, or infection e.g.
redness, swelling, warmth.
ii. Ensure that the correct amount of blood was collected and labeled
properly
iii. Monitor the patient for any discomfort or adverse reactions.
iv. Confirm that the patient understands post-procedure care
instructions
v. Ensure no complications occurred during or after the procedure.
B. BLOOD SMEAR NURSING MANAGEMENT
The methods of collection of blood for blood smear include Venipuncture,
Capillary blood collection(fingerstick) and Arterial Blood Collection.
Assessment
i. Assess the patient’s understanding of the procedure and its
purpose.
ii. Review medical history for any conditions affecting blood
collection, such as clotting disorders.
iii. Check for signs of infection or inflammation at the site of
blood collection.
iv. Assess the patient’s ability to tolerate a fingerstick or
venipuncture, depending on the method used.
v. Ensure the availability of clean slides, lancets, capillary tubes,
gloves, and staining reagents.
Diagnosis
i. Risk for impaired skin integrity related to fingerstick or
venipuncture.
ii. Anxiety related to fear of needles or the unknown.
iii. Risk for impaired skin integrity related to fingerstick or
venipuncture.
iv. Risk for infection related to invasive procedure
Planning
Goals:
i. Obtain an adequate blood sample for preparing a high-quality
smear.
ii. Minimize patient discomfort and anxiety.
iii. Prevent contamination or sample mislabeling.
Preparation:
i. Identify the appropriate site (fingerstick or venipuncture) for blood
collection.
ii. Gather necessary equipment, including clean slides and reagents.
iii. Plan to handle the sample promptly to ensure accuracy in results.
Implementation
Pre-Procedure:
i. Explain the procedure to the patient to reduce anxiety.
ii. Perform hand hygiene and wear gloves.
iii. If using a fingerstick, warm the site (e.g., by rubbing or using a
warm compress) to improve blood flow.
During the Procedure:
i. Collect a small drop of blood using either a fingerstick or
venipuncture method.
ii. Place the drop of blood near one end of a clean glass slide.
iii. Use another slide to spread the blood drop evenly into a thin film
with a feathered edge.
iv. Allow the slide to air-dry completely before staining.
Post-Procedure:
i. Dispose of used lancets, needles, and other sharps in appropriate
containers.
ii. Clean any blood spills and sanitize the area.
iii. Label the slide with the patient’s information to prevent errors.
Evaluation
i. Inspect the blood smear for quality e.g. even distribution, feathered
edge.
ii. Confirm proper labeling and handling of the slide for laboratory
analysis.
iii. Monitor the patient for any adverse reactions or signs of infection.
iv. Ask the patient if they experienced any discomfort or had questions
about the procedure.
v. Confirm the patient’s understanding of the next steps, such as
waiting for results.
References
i. Lewis’s Medical-Surgical Nursing: Assessment and
Management of Clinical Problems. Elsevier. Harding, M. M.,
Kwong, J., Roberts, D., Hagler, D., & Reinisch, C. (2020).
ii. Medical-Surgical Nursing 10th Edition by Brunner &
Suddarth.
iii. Fundamentals of Nursing: Standards & Practice Fourth
Edition. Sue C. Delaune, Patricia K. Ladner.
