Collection ProceduresQuestion 18 of 100

A patient had a right mastectomy with lymph node removal 14 months ago and has an IV in the left hand. What should the phlebotomist do?

a.Draw from the right antecubital area since the surgery was over a year ago
b.Draw above the IV in the left arm
c.Use a fingerstick on the right hand without asking anyone
d.Consult the patient's provider for guidance before selecting a site

Explanation

Lymph node dissection impairs lymph drainage indefinitely, so the affected side is avoided because of infection and lymphedema risk, and there is no automatic time limit that makes it safe. With the only other arm carrying an IV, the correct step is to obtain provider direction rather than choose unilaterally. Drawing above an IV dilutes the sample, and a fingerstick on the affected side carries the same restriction as a venipuncture.

Law Reference: CLSI GP41

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