48. A dialysis patient in the ICU has a shunt placement in the right forearm and an IV placed in the left hand. Which of the following options best describes the optimal site collection of a CBC?
Answer: C
The optimal site for collecting a CBC is the left antecubital fossa.
Collecting a CBC from the left antecubital fossa is optimal in this scenario due to the presence of the shunt in the right forearm, which poses a risk of contamination and inaccurate results from the dialysis access.
A) The right antecubital fossa
Collecting a CBC from the right antecubital fossa is inappropriate because there is a shunt placement in the right forearm. This shunt is primarily used for dialysis and could lead to complications or contamination of the blood sample.
B) The right hand
While it may seem feasible to collect a CBC from the right hand, this site is not optimal due to the presence of the shunt in the right forearm. The shunt may affect the quality of the sample, making it less reliable for accurate testing.
C) The left antecubital fossa
The left antecubital fossa is the optimal site for collecting a CBC in this case. Since the shunt is located in the right forearm, using the left antecubital fossa avoids complications and ensures a clean, accurate sample without interference from the dialysis access.
D) Capillary collection of the left hand
Capillary collection of the left hand is not optimal for a CBC as it typically yields smaller blood volumes and may not provide sufficient sample size for accurate testing. Additionally, it can be more prone to contamination compared to venous sampling from the antecubital fossa.
Conclusion
In summary, the left antecubital fossa is the best choice for collecting a CBC due to the presence of the shunt in the right forearm. All other options fail to provide an appropriate site due to either contamination risks or insufficient sample size, reinforcing the need for careful consideration in blood sample collection in patients with dialysis access.