Final answer:
A phlebotomist may palpate surface veins in the arm, such as the median cubital, cephalic, or basilic veins on an obese patient. The skeletal muscle pump helps in venous return, and a lack of physical activity in an obese individual can exacerbate circulation issues, contributing to symptoms like swollen ankles and fatigue.
Step-by-step explanation:
The vein a phlebotomist may palpate on an obese patient is typically one of the more accessible surface veins in the arm, such as the median cubital vein, cephalic vein, or basilic vein. In obese patients, veins can be harder to palpate due to the additional fatty tissue, so the phlebotomist will need to rely on experience and skill to locate a suitable vein for venipuncture.
In the case of the patient mentioned, swollen feet and ankles, fatigue, shortness of breath, and feeling "spaced out" could be signs of poor circulation and possibly venous insufficiency. The skeletal muscle pump is crucial in aiding blood return from the lower extremities to the heart, especially in individuals who stand for long periods or are sedentary. The lack of muscle contraction can lead to pooling of blood in the legs, contributing to these symptoms. Regular physical activity helps to promote the action of the skeletal muscle pump, and a lack thereof might exacerbate the patient's signs and symptoms.