Blood Cultures

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Study Tools For Blood Cultures

Blood Culture Collection Cheatsheet (Cheatsheet)
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Outline

Overview

  1. Purpose
    1. Obtaining blood cultures for testing without contaminating the sample

Nursing Points

General

  1. Supplies needed
    1. All supplies for venipuncture
      1. Antiseptic scrub
    2. Two sets of blood culture bottles
    3. Alcohol pads
    4. Needle or transfer device for getting blood into the bottles
    5. Patient labels

Nursing Concepts

  1. Steps and Nursing Considerations
    1. Perform all proper steps for venipuncture
    2. If obtaining via venipuncture, scrub skin with antiseptic scrub for a FULL minute and let dry
    3. Do NOT touch the skin after cleansing
    4. If using a butterfly directly from patient into bottle:
      1. Fill aerobic bottle first
      2. Minimum 5 mL in each
    5. If using syringe method
      1. Attach needle and purge air out of needle until a drop of blood is seen
      2. Fill anaerobic bottle first
      3. Minimum 5 mL in each
    6. Do NOT allow large air bubbles to enter the anaerobic bottle
    7. Label the bottles
      1. Patient identifiers
      2. Time and date of draw
      3. Your initials
      4. Location of draw (i.e. Rt arm, Lt AC)
  2. Blood cultures should be drawn from two sites, preferably on opposite sides if possible
  3. Blood cultures should NEVER be drawn off an existing line without explicit orders from a provider
    1. A positive culture from an existing line assumes the line itself is infected

Patient Education

  1. Purpose for blood cultures
  2. Preliminary results in 24 hours, final results in 48-72 hours

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Transcript

In this video, we’re going to look at the priorities when drawing blood cultures. Specifically, in the drawing blood lesson we talked about how to do a venipuncture. One of the most important things you need to take from that lesson, though, is that when you’re drawing blood for cultures, you MUST scrub the site with an antiseptic scrub for a FULL minute. The #1 source of contamination in blood cultures is the bacteria found on the skin.

So, go back and watch that video if you need to. Right now we’re going to talk specifically about how to get the blood INTO the blood culture bottles appropriately. In school they tell you “pink then green, because ladies first” or something they want you to memorize. Well, you guys know we’re not all about that. We want you to UNDERSTAND the why behind the what and how to know which bottle to do first. One bottle will be for aerobic bacteria – that’s bacteria that can survive in air. The other bottle will be for anaerobic bacteria – ones that CAN’T survive in air. So when you’re thinking about which bottle to do first – always think about where the AIR is!!
If you’re using a butterfly needle like this and you’re going to insert it into the patient’s arm and then directly into the bottle – where is ALL of this air going to go?? Right into the bottle. So if I put it into the anaerobic bottle – all those bacteria are going to die and I’m not going to be able to test them, right? So in THIS case, you start with aerobic.
Now let’s think about if you had a syringe full of blood with a needle that you were going to insert into the bottles. If I turn this syringe upside down, where did the air bubbles go? They went to the top, right? So if I put 4 or 5 mL of blood in each bottle from the same syringe, the AIR will go in the second bottle. So which one do I do first? Anaerobic!
Now, let’s show you what this looks like. You really only need 5 mL of blood in each bottle, so if you have a syringe with 10 mL of blood, you’re going to split it. But that vacuum is SUPER strong, so you have to watch closely. First, clean the tops of the blood culture bottles – each with their own alcohol pad so you don’t cross contaminate. Then, purge any air out of the needle JUST until you see a drop of blood at the end. Then, insert the syringe first into the anaerobic bottle – as SOON as it drops down to 5 mL, pull straight out. Then, insert it into the aerobic bottle and let the rest of the blood go into that one.
When you’re done, of course you’re going to carefully place the syringe and needle directly into a sharps container.
When you draw blood cultures, you’re going to be using two different sites, usually from opposite arms. So when you label the bottles, you put the patient information, time, date, your initials, AND the location you drew that blood from – like “right arm” or “Left AC”. We NEVER draw blood cultures out of a line without explicit orders from the provider.
Then bag them up and send them to the lab as you normally would! You should get preliminary results in about 24 hours!
We hope that was helpful for blood cultures. Make sure you check out the “drawing blood” video to learn about venipuncture. And remember with Blood Cultures, we’re trying to avoid contamination at all costs, so clean the site REALLY well and don’t touch the site before you stick it, and clean the tops of the bottles with their own alcohol scrub! And, of course, make sure you don’t put air into the Anaerobic bottle.

We love you guys! Go out and be your best selves today. And, as always, happy nursing!

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Nursing Clinical 360

With the rapid expansion of the COVID-19 pandemic many schools, instructors and students are left wondering what just happened?Students can’t access the tools and onsite clinical help they desperately need and instructors are trying to piece together online learning that prepares their students for success.It is because of this uncertainty and abrupt change that we have developed the Nursing Clinical 360 Course.Featuring:38 Highly Detailed Nursing Skills Video Lessons18 Health Assessment Lessons26 IV Skills Videos42 Case Studies30+ Care PlansWe want to give students the practical knowledge they need to feel confident going into a clinical or practical situation, as well as give instructors a concise library of online resources to handle the sudden demand for distance learning.

Course Lessons

1 - Head to Toe and Health Assessment
Intro to Health Assessment
Barriers to Health Assessment
The 5-Minute Assessment (Physical assessment)
Adult Vital Signs (VS)
Pediatric Vital Signs (VS)
General Assessment (Physical assessment)
Integumentary (Skin) Assessment
Neuro Assessment
Head/Neck Assessment
EENT Assessment
Heart (Cardiac) and Great Vessels Assessment
Thorax and Lungs Assessment
Abdomen (Abdominal) Assessment
Lymphatic Assessment
Peripheral Vascular Assessment
Musculoskeletal Assessment
Genitourinary (GU) Assessment
2 - IV Insertion
Supplies Needed
Using Aseptic Technique
Selecting THE vein
Tips & Tricks
IV Catheter Selection (gauge, color)
IV Insertion Angle
How to Secure an IV (chevron, transparent dressing)
Drawing Blood from the IV
Maintenance of the IV
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
Needle Safety
IV Drip Therapy – Medications Used for Drips
IV Drip Administration & Safety Checks
Understanding All The IV Set Ports
Giving Medication Through An IV Set Port
How to Remove (discontinue) an IV
IV Placement Start To Finish (How to Start an IV)
Bariatric: IV Insertion
Dark Skin: IV Insertion
Tattoos IV Insertion
Geriatric: IV Insertion
Combative: IV Insertion
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
3- Nursing Skills
Nursing Skills (Clinical) Safety Video
Bed Bath
Linen Change
PPE Donning & Doffing
Sterile Gloves
Mobility & Assistive Devices
Spinal Precautions & Log Rolling
Restraints
Starting an IV
Drawing Blood
Blood Cultures
Central Line Dressing Change
Inserting a Foley (Urinary Catheter) – Female
Inserting a Foley (Urinary Catheter) – Male
Trach Suctioning
Trach Care
Inserting an NG (Nasogastric) Tube
NG (Nasogastric)Tube Management
NG Tube Med Administration (Nasogastric)
Stoma Care (Colostomy bag)
Wound Care – Assessment
Wound Care – Selecting a Dressing
Wound Care – Dressing Change
Wound Care – Wound Drains
Pill Crushing & Cutting
EENT Medications
Topical Medications
Drawing Up Meds
Medications in Ampules
Insulin Mixing
SubQ Injections
IM Injections
IV Push Medications
Spiking & Priming IV Bags
Hanging an IV Piggyback
Chest Tube Management
Pressure Line Management
4- Nursing Care Plans
Purpose of Nursing Care Plans
How to Write a Nursing Care Plan
Using Nursing Care Plans in Clinicals
Nursing Care Plan (NCP) for Abdominal Pain
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Alcohol Withdrawal Syndrome / Delirium Tremens
Nursing Care Plan (NCP) for Alzheimer’s Disease
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Aortic Aneurysm
Nursing Care Plan (NCP) for Appendicitis
Nursing Care Plan (NCP) for Arterial Disorders
Nursing Care Plan (NCP) for Asthma
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Benign Prostatic Hyperplasia (BPH)
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Cholecystitis
Nursing Care Plan for Cirrhosis (Liver)
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Constipation / Encopresis
Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis
Nursing Care Plan (NCP) for Eating Disorders (Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder)
Nursing Care Plan (NCP) for Endocarditis
Nursing Care Plan (NCP) for Dehydration & Fever
Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia
Nursing Care Plan (NCP) for GI (Gastrointestinal) Bleed
Nursing Care Plan (NCP) for Heart Valve Disorders
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care Plan (NCP) for Inflammatory Bowel Disease (Ulcerative Colitis / Crohn’s Disease)
Nursing Care Plan (NCP) for Leukemia
Nursing Care Plan (NCP) for Mood Disorders (Major Depressive Disorder, Bipolar Disorder)
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Neutropenia
Nursing Care Plan (NCP) for Pancreatitis
Nursing Care Plan (NCP) for Parkinson’s Disease
Nursing Care Plan (NCP) for Peptic Ulcer Disease (PUD)
Nursing Care Plan (NCP) for Schizophrenia
Nursing Care Plan (NCP) for Seizures
Nursing Care Plan (NCP) for Spinal Cord Injury
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Nursing Care Plan (NCP) for Vomiting / Diarrhea
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Osteoporosis
Nursing Care Plan (NCP) for Congenital Heart Defects
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Rheumatoid Arthritis (RA)
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Nursing Care Plan (NCP) for Thrombocytopenia
Nursing Care Plan (NCP) for Sickle Cell Anemia
Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV)
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Post-Traumatic Stress Disorder (PTSD)
Nursing Care Plan (NCP) for Glomerulonephritis
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Renal Calculi
5- Nursing Concept Maps
Concept Map Course Introduction
Coronary Artery Disease Concept Map
COPD Concept Map
Asthma Concept Map
Pneumonia Concept Map
Bowel Obstruction Concept Map
Gastrointestinal (GI) Bleed Concept Map
Congestive Heart Failure Concept Map
Hypertension (HTN) Concept Map
Breast Cancer Concept Map
Amputation Concept Map
Sepsis Concept Map
Stroke Concept Map
Depression Concept Map