Drawing Blood from the IV

You're watching a preview. 300,000+ students are watching the full lesson.
Chance Reaves
MSN-Ed,RN
Master
To Master a topic you must score > 80% on the lesson quiz.

Included In This Lesson

NURSING.com students have a 99.25% NCLEX pass rate.

Outline

Nursing Points

General

  1. Candidates for drawing blood through the IV
    1. Most EBP recommends against drawing through IVs
    2. Candidates for this procedure are:
      1. Difficult access
      2. Patient noncompliance
      3. Those getting a freshly IV placed
    3. Only draw through an IV when necessary
  2. Prior to collecting a blood sample
    1. Verify the order for the need to collect blood
    2. Look for other options of collecting blood that do not require another needle stick
      1. Central line access/midline/PICC
  3. Drawing the blood of a Fresh IV is best
    1. Start the IV and secure
    2. Attach a vacutainer
    3. Collect blood specimens that are ordered
    4. Disconnect vacutainer and flush the line
    5. The IV site must be
      1. Patent
      2. Must have blood return
      3. Must have an infusion that can be paused
    6. Consider alternate options if
      1. The IV does not flush easily
      2. There is no blood return
      3. The infusion cannot be stopped
  4. Tips and Tricks
    1. Don’t withdraw the sample too quickly
      1. Can cause hemolysis of the sample, requiring a redraw
    2. For samples that have slow blood return
      1. The hub of the catheter can be manipulated up and down slightly
        1. Be careful to not dislodge the catheter

Unlock the Complete Study System

Used by 300,000+ nursing students. 99.25% NCLEX pass rate.

200% NCLEX Pass Guarantee.
No Contract. Cancel Anytime.

Transcript

Okay. Guys, in this lesson we’re going to take a look at when you would actually draw blood from an IV. The first thing you need to know is it’s not recommended based on evidence. There’s a lots of things that are out there that show that this can actually cause a lot of problems. There are devices on the market that allow you to draw blood through a peripheral IV, but there’s a lot of training, uh, and there’s just more that goes into it. However, that being said, if you have the opportunity when you first go to insert an IV that your patient has good blood return, it doesn’t hurt anything because it’s so fresh to actually get a sample. The first thing that you need to do before you even put the IV in is to make sure that you have an order for all your labs. 

You want to make sure that you have an order for the IV as well, but also make sure that you know specifically what blood tubes you need. Are you going to need a purple top? Are you going to submit a CBC or lactate? There’s lots of things that you can do off that fresh stick, but the thing that you want to remember is that as you do it, you want to make sure that you’re not causing damage to the IV itself. If you’re getting blood this way on that patient’s IV stick, make sure that you’re using minimal negative pressure. The reason you want to do this is you also don’t want to collapse that brand new IV that you placed caused patient problems because of a collapsed vessel and now you have an IV that doesn’t work. But the other thing is you don’t want to cause problems with your blood sample. 

That negative, that extreme negative pressure can actually cause a lysing of those cells and then you’re going to have to redraw anyway and it becomes a big pain. So just make sure that it’s a nice fluid motion with minimal negative pressure. If you get resistance and it stops flowing back, call it a day and make sure that you get blood by other means necessary, whether that’s a fresh stick which is actually indicated, or if your patient has a different type of, uh, access. Maybe central access with several different lumens, maybe a pic, a, there are several different options that you can go for. It doesn’t always have to be through that PIV. Now take a look at this video to see how to safely draw blood from an IV, but you get your IV set in the vein. What you’re going to do is you’re going to grab the flush and you’re going to actually withdraw the sample that you need, and once you get that sample, the first thing you’re going to do is waste three to five miles, and then you’re going to pull the actual sample that you need.

After that, make sure you hook up a new flush and you want to flush that line that you just worked really hard to get. Grab a new flush in. The other thing you want to do is make sure that you’re not clamped and to make sure that line stays Peyton. You’re going to reflush and then after that, you’re going to make sure that you spend the time securing that IV. Now that you’ve got your sample. What you’re gonna do is take this blunt tip plastic Canyon and you’re gonna attach it to the sample syringe. After you do that, then you’re going to do is grab the necessary vacuum tanners or vials that you need. Use that blunt tip. You don’t want to poke yourself, apply pressure and then what’s going to happen is you’re going to fill up this a tube, the blood tube and what you want to do is you want to continue filling that blood tube all the way up as full as it needs to be.

This is indicated on the label with that little black Mark you want to fill to that designated line. One other tip that you can employ is if your patient does start to have a little bit of a sluggish blood return, which you can actually do is manipulate the hub of the catheter up and down just slightly to maybe change the angle and you can sometimes get some blood back from that, but again, if it doesn’t work, call it a day and move on. I hope that these tips have been helpful. Now go out and be your best selves today. And as always, happy nursing.

 

Study Faster with Full Video Transcripts

99.25% NCLEX Pass Rate vs 88.8% National Average

200% NCLEX Pass Guarantee.
No Contract. Cancel Anytime.

🚨PRICE INCREASE COMING

Lock in Lifetime Access at OVER 50% Off

reg $499 → $199

or 5 payments of $39.99

Ends January 17

Adaptive Brain SIMCLEX 1 Study Plan

Concepts Covered:

  • Documentation and Communication
  • Legal and Ethical Issues
  • Perioperative Nursing Roles
  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient
  • Intraoperative Nursing
  • Microbiology
  • Communication
  • Fundamentals of Emergency Nursing
  • Preoperative Nursing
  • Basics of NCLEX
  • Medication Administration
  • Vascular Disorders
  • Upper GI Disorders
  • Urinary Disorders
  • Renal Disorders
  • Central Nervous System Disorders – Brain
  • Studying
  • Emergency Care of the Neurological Patient
  • Postpartum Complications
  • Liver & Gallbladder Disorders
  • Factors Influencing Community Health
  • Community Health Overview
  • Immunological Disorders
  • Integumentary Disorders
  • Male Reproductive Disorders
  • Pregnancy Risks
  • Prioritization
  • Childhood Growth and Development
  • Musculoskeletal Trauma
  • Terminology
  • Respiratory Disorders
  • Cognitive Disorders
  • Adulthood Growth and Development
  • EENT Disorders
  • Concepts of Population Health
  • Basic
  • Disorders of the Adrenal Gland
  • Disorders of the Thyroid & Parathyroid Glands
  • Tissues and Glands
  • Emergency Care of the Trauma Patient
  • Cardiovascular
  • Lower GI Disorders
  • Circulatory System

Study Plan Lessons

The Top 5 Things You Need To Know About Documentation 2 – Live Tutoring Archive
Ethical and Professional Standards for Certified Perioperative Nurse (CNOR)
Ventricular Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Hazardous Material Handling and Disposition (Chemo, Radioactive) for Certified Perioperative Nurse (CNOR)
Biohazard Material Handling and Disposition (Blood, Microbiology, Creutzfeldt-Jakob Disease) for Certified Perioperative Nurse (CNOR)
Function Within Scope of Practice for Certified Perioperative Nurse (CNOR)
Patient Communication Techniques for Certified Perioperative Nurse (CNOR)
Patient Confidentiality for Certified Perioperative Nurse (CNOR)
Patient Status Communication for Certified Perioperative Nurse (CNOR)
Conflict Management (Patient, Perioperative Team, Family) for Certified Perioperative Nurse (CNOR)
Patient Rights Advocacy for Certified Perioperative Nurse (CNOR)
Advanced Directive and DNR Status Confirmation for Certified Perioperative Nurse (CNOR)
Patient Privacy and Dignity Maintenance for Certified Perioperative Nurse (CNOR)
Caring Practices for Progressive Care Certified Nurse (PCCN)
Cardiac Labs – What and When to Use Them 2 – Live Tutoring Archive
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Atenolol (Tenormin) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Atrial Fibrillation (A Fib)
Interventional Radiology
Nursing Care and Pathophysiology of Renal Calculi (Kidney Stones)
Renal Calculi for Certified Emergency Nursing (CEN)
Seizure Causes Nursing Mnemonic (VITAMIN)
Seizure Assessment
Medications to Prevent Seizures Nursing Mnemonic (Pretty Little Liars Forever)
Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)
Meds for Postpartum Hemorrhage (PPH)
Postpartum Hemorrhage (PPH)
Restraints
Sexual Assault and Battery for Certified Emergency Nursing (CEN)
Forensic Nurse
Antimicrobial Vaccinations
Hb (Hepatitis) Vaccine
Sucralfate (Carafate) Nursing Considerations
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Gastrointestinal (GI) Bleed Concept Map
Oral Medications
Intubation in the OR
Access to Care
Community Health Nursing Theories
Health Promotion Model
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Hypertension for Certified Emergency Nursing (CEN)
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
AIDS Case Study (45 min)
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Bed Bath
Nursing Care Plan for Testicular Torsion
Nursing Care and Pathophysiology for Testicular Torsion
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Protein (PROT) Lab Values
Magnesium Sulfate
Safety Checks
Legalities of Charting
Nursing Skills (Clinical) Safety Video
Prioritization
Patient Consent for Treatment for Certified Emergency Nursing (CEN)
Advance Directives
Mechanisms of Antimicrobial Agents
Healthcare-Acquired Infections: Central-Line-Associated Infections (CLABSI) for Progressive Care Certified Nurse (PCCN)
Cefdinir (Omnicef) Nursing Considerations
Growth & Development – Infants
Nursing Care Plan for Amputation
Amputation
Amputation for Certified Emergency Nursing (CEN)
Healthcare-Acquired Infections: Catheter-Associated Bloodstream Infections (CAUTI) for Progressive Care Certified Nurse (PCCN)
Nursing Care Plan (NCP) for Urinary Tract Infection (UTI)
Urinary Retention for Certified Emergency Nursing (CEN)
Causes of Anaphylaxis Nursing Mnemonic (Many Boys Love Food)
Anaphylaxis Nursing Interventions for Certified Perioperative Nurse (CNOR)
Hypoxia – Signs and Symptoms Nursing Mnemonic (RAT BED)
Radiation Safety for Nurses
Legal Considerations
Fall and Injury Prevention
Diagnostics Terminology
Procedural Terminology
Diagnostic Testing Course Introduction
Hydrochlorothiazide (Hydrodiuril) Nursing Considerations
Cardiac (Heart) Disease in Pregnancy
Needle Safety
Nursing Care Plan (NCP) for Incompetent Cervix
Incompetent Cervix
Pediatric Bronchiolitis Labs
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV)
Risk Factors for Cholelithiasis Nursing Mnemonic (5-F’s)
Nursing Care and Pathophysiology for Cholecystitis
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Nursing Care Plan (NCP) for Dementia
Dementia and Alzheimers
Pain Management for the Older Adult – Live Tutoring Archive
Growth & Development – Late Adulthood
Geriatric: IV Insertion
Cataracts
Communicable Diseases
CPR-BLS (Basic Life Support)
Brief CPR (Cardiopulmonary Resuscitation) Overview
Adrenal and Thyroid Disorder Emergencies for Certified Emergency Nursing (CEN)
Addisons Assessment Nursing Mnemonic (STEROID)
Addisons Disease
The Customer Voice
Patient Education
Advocating For Your Patient
IV Infusions (Solutions)
Tips & Advice for Pediatric IV
Tattoos IV Insertion
Trauma Survey
Head Trauma & Traumatic Brain Injury
Nursing Case Study for Head Injury
Myocardial Infarction Nursing Mnemonic (MONATAS)
Streptokinase (Streptase) Nursing Considerations
02.13 Myocardial Infarction – Anterior Septal Wall for CCRN Review
GI Infections (C. difficile) for Progressive Care Certified Nurse (PCCN)
C. Difficile for Certified Emergency Nursing (CEN)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Urinary Tract Infection Case Study (45 min)
Phenazopyridine (Pyridium) Nursing Considerations
Common Pathogens for UTI Nursing Mnemonic (KEEPS)
Drawing Blood
Order of Lab Draws
Drawing Blood from the IV