A client has an order to have radial ABG drawn. Before drawing the sample, a nurse occludes the:
A. Brachial and radial arteries, and then releases them and observes the circulation of the hand.
B. Radial and ulnar arteries, releases one, evaluates the color of the hand, and repeats the process with the other artery.
C. Radial artery and observes for color changes in the affected hand.
D. Ulnar artery and observes for color changes in the affected hand.
Correct Answer: B. Radial and ulnar arteries, releases one, evaluates the color of the hand, and repeats the process with the other artery.
Before drawing an ABG, the nurse assesses the collateral circulation to the hand with Allen’s test. This involves compressing the radial and ulnar arteries and asking the client to close and open the fist. This should cause the hand to become pale. The nurse then releases pressure on one artery and observes whether circulation is restored quickly. The nurse repeats the process, releasing the other artery. The blood sample may be taken safely if collateral circulation is adequate.
Option A: Puncture of the radial artery is usually preferred because of the accessibility of the vessel, the presence of collateral circulation, and the artery’s superficial course proximal to the wrist, which makes it easier for the clinician to identify the vascular structure and hold local pressure after the procedure is finished.
Option C: The radial artery is most easily accessible medial to the radial styloid process and lateral to the flexor carpi radialis tendon, 2-3 cm proximal to the ventral surface of the wrist crease. Firm occlusive pressure is held on both the radial artery and the ulnar artery. The patient is asked to clench the fist several times until the palmar skin is blanched, then to unclench the fist.
Option D: If radial artery sampling is not feasible, femoral artery puncture is a possible alternative. When femoral artery puncture is being considered, the potential risk of infection at the entry site and the artery’s proximity to the femoral vein and nerve must be taken into
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