The most serious complication of an infant heelstick is necrotizing osteochondritis resulting from lancet penetration of the bone. What approach should the nurse take when performing the test to prevent this complication?
A.
Lancet should penetrate the ball of the foot.
B.
Lancet should penetrate at the outer aspect of the heel.
C.
Lancet should penetrate the area just below the fifth toe.
D.
Lancet should penetrate the walking surface of the heel.
The correct answer and Explanation is :
The correct answer is:
B. Lancet should penetrate at the outer aspect of the heel.
Explanation:
A heel stick is a common procedure used to collect blood samples from infants, particularly newborns. While the procedure is generally safe, it is crucial that the nurse performs it correctly to avoid complications, the most serious of which is necrotizing osteochondritis, a condition caused by the lancet penetrating too deeply and injuring the bone or cartilage.
To prevent this complication, the outer aspect of the heel (lateral or medial sides) should be used. This area is away from the calcaneus (heel bone) and has a thicker layer of tissue, reducing the risk of penetrating too deeply and reaching the bone.
Why B is Correct:
- The outer aspect of the heel provides a safer puncture site because it has fewer underlying bone structures, making it less likely for the lancet to reach the bone.
- This area is considered safe due to its relatively thick skin and tissue layers that provide adequate padding.
- When performing the heel stick, the lancet should only penetrate the skin to a depth of approximately 2 mm to avoid reaching deeper tissues.
Why the Other Options are Incorrect:
- A. Penetrating the ball of the foot: This area has less soft tissue and is closer to bones and cartilage, increasing the risk of injury to these structures.
- C. Just below the fifth toe: This area is also close to bones and is not recommended for heel sticks due to the lack of protective soft tissue.
- D. The walking surface of the heel: This area contains significant bone structure and is not appropriate for a heel stick, as it increases the risk of necrotizing osteochondritis.
Proper site selection and technique are critical in ensuring the safety and well-being of the infant during blood collection procedures.