A registered nurse in a postpartum unit is preparing to perform a mandatory newborn metabolic screening (heel stick) on a 36-hour-old infant. To ensure an accurate health screening sample and prevent complications, in what order should the nurse perform the following actions? Arrange the steps in the correct sequence.
- 1Apply a warm, moist compress to the infant's heel for 3 to 5 minutes.
- 2Cleanse the lateral plantar surface with an antiseptic swab and allow it to air dry completely.
- 3Puncture the skin using a sterile, spring-loaded neonatal lancet.
- 4Wipe away the initial drop of blood using a dry, sterile gauze pad.
- 5Lightly touch the filter paper to a newly formed large blood drop to completely fill the printed circle.
Answer
The correct sequence is to warm the heel, cleanse and dry the site, puncture the lateral plantar surface, wipe away the first drop of blood, and finally collect the subsequent sample on the filter paper.
The correct sequence for a newborn metabolic screening heel stick ensures optimal blood flow, prevents sample contamination, and guarantees accurate laboratory results. Warming the heel increases perfusion. Cleansing and complete air drying prevent hemolysis and infection. The puncture must be performed on the lateral plantar surface to avoid bone injury. Wiping the first drop removes tissue fluids that can dilute the sample, and properly saturating the filter paper circles ensures a valid specimen for the health screening.
Step-by-Step Solution
Key Concept
Newborn Metabolic Screening Procedure and Specimen Integrity