ATI - Specimen Collection - "Blood glucose measurement" - wk2

Question 1

living only in the presence of oxygen

Answer 1

aerobic

Question 2

living only in the absence of oxygen

Answer 2

anaerobic

Question 3

pertaining to an artery (a blood vessel that carries blood from the heart to the rest of the body)

Answer 3

arterial

Question 4

the fluid that circulates in the heart and blood vessels carrying nourishment and oxygen to and bringing waste products from all parts of the body

Answer 4

blood

Question 5

laboratory cultivation of micro-organisms in a blood sample placed in a special growth medium

Answer 5

blood culture

Question 6

a flexible tube passed into the body to remove or instill fluids or to keep a passageway open

Answer 6

catheter

Question 7

sample of urine collected after beginning to urinate into the toilet, stopping the stream of urine, then urinating into a sterile collection cup

Answer 7

clean-voided (midstream) specimen

Question 8

laboratory cultivation of micro-organisms in a body fluid or substance placed in a special growth medium

Answer 8

culture

Question 9

laboratory cultivation of micro-organisms in a body fluid or substance placed in a special growth medium, followed by the identification of the antibiotic agents that can kill the pathogenic micro-organisms grown

Answer 9

culture & sensitivity (C&S)

Question 10

seepage or withdrawal of fluids from a wound, cavity, or orifice

Answer 10

drainage

Question 11

material such as fluid with a high content of protein and cellular debris that has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation

Answer 11

exudate

Question 12

pertaining to feces, the solid waste eliminated from the intestines through the anus; stool

Answer 12

fecal

Question 13

pertaining to the stomach

Answer 13

gastric

Question 14

a tree resin used as a reagent in the detection of occult (hidden) blood

Answer 14

guaiac

Question 15

a device used to determine the approximate concentration of glucose in the blood

Answer 15

glucometer

Question 16

a simple sugar that is the end product of carbohydrate metabolism

Answer 16

glucose

Question 17

glucose in the urine

Answer 17

glucosuria

Question 18

blood in the urine

Answer 18

hematuria

Question 19

rupture of red blood cells, resulting in the release of hemoglobin into the plasma

Answer 19

hemolysis

Question 20

any of a class of organic compounds (such as acetone) that are the normal end products of the metabolism of stored fats; accumulation in the urine (ketonuria) is a sign of hyperglycemia in people who have diabetes mellitus

Answer 20

ketones

Question 21

a sharp, pointed device used to make small incisions or punctures in the skin

Answer 21

lancet

Question 22

a white blood cell

Answer 22

leukocyte

Question 23

an enzyme found in some white blood cells, the presence of which in urine is a sign of infection

Answer 23

leukocytes esterase

Question 24

a substance used to cultivate micro-organisms in a laboratory (plural: media)

Answer 24

medium

Question 25

black, tarry feces created by the action of intestinal secretions on blood

Answer 25

melena

Question 26

blood present in such small amounts as to be detectable only by specific diagnostic tests

Answer 26

occult blood

Question 27

a measure of the acidity or alkalinity of a substance, with a low pH indicating acidity and a high pH indicating alkalinity; a measure of the concentration of hydrogen ions

Answer 27

pH

Question 28

a disposable indicator that measures the acidity or alkalinity of a substance, with a low pH indicating acidity and a high pH indicating alkalinity

Answer 28

pH test strip

Question 29

the process of accessing a vein for blood sampling or treatment

Answer 29

phlebotomy

Question 30

at or near the site or time of patient care, as in point-of-care testing

Answer 30

point of care

Question 31

excretion of abnormally large amounts of urine

Answer 31

polyuria

Question 32

a small portion that represents the whole of body cells, fluid, secretions, or excretions, collected for the purposes of diagnostic testing

Answer 32

sample

Question 33

the presence of infective agents or their toxins in the bloodstream

Answer 33

septicemia

Question 34

the weight or degree of concentration of a substance compared with that of an equal volume of another substance, most often, urine compared with distilled water

Answer 34

specific gravity

Question 35

a small portion that represents the whole of body cells, fluid, secretions, or excretions, collected for the purposes of diagnostic testing

Answer 35

specimen

Question 36

mucous secretions from the lungs, bronchi, and trachea

Answer 36

sputum

Question 37

measures designed to prevent the transmission of organisms and used for all patients in healthcare facilities regardless of diagnosis or infection status

Answer 37

standard precautions

Question 38

free from living organisms and especially from micro-organisms and pathogens

Answer 38

sterile

Question 39

solid waste eliminated from the intestines through the anus; fecal matter

Answer 39

stool

Question 40

a small pledget of cotton or gauze wrapped around the end of a slender stick used to apply medications or solutions or to obtain specimens from body surfaces or orifices

Answer 40

swab

Question 41

an instrument used to introduce fluids into or withdraw them from the body

Answer 41

syringe

Question 42

a stretchable device used to compress blood vessels either to stop bleeding or to assist in obtaining blood samples

Answer 42

touniquet

Question 43

a diagnostic examination of urine

Answer 43

urinalysis

Question 44

a chemically treated band that, when dipped into a urine sample and color changes are observed, yields information about pH, specific gravity, leukocytes or leukocyte esterase, blood, ketones, bilirubin or urobilinogen, and glucose (varying with the type of test strip used)

Answer 44

urine reagent test strip

Question 45

a trade name for an evacuated blood collection tube system

Answer 45

vacutainer

Question 46

insertion of a needle into a vein to withdraw blood samples or to establish ongoing access to a vein

Answer 46

venipuncture

Question 47

pertaining to a vein (a blood vessel that carries blood to the heart from the rest of the body)

Answer 47

venous

Question 48

a plastic or glass container in which liquid or powdered medication is packaged in an airtight and sterile environment and sealed with a rubber stopper

Answer 48

viral

Question 49

an injury to the body that typically involves laceration or breaking of the skin or mucous membranes and usually damage to underlying tissue

Answer 49

wound

Question 50

My alert and oriented patient’s blood glucose reading was 435 after his afternoon snack. What should be my next step?

Answer 50

Monitor the patient continuously. Check agency protocol for laboratory confirmation testing of very high readings, as laboratory testing is considered more accurate. Attain the patient’s medical record for a medication prescription related to increased glucose. Administer insulin or a carbohydrate source per provider prescription and notify the health care provider of the patient’s response.

Question 51

What indications of UTI should I check for before I do a urine reagent strip test or request a urinalysis order from the provider?

Answer 51

Key features indicating a urinary tract infection are frequent urination, urgency, hesitancy or difficulty initiating a stream, retention, feeling of incomplete emptying, burning or pain with urination, low-back or flank pain, hematuria (blood in the urine), pyuria, foul-smelling urine, cloudy urine, fever, incontinence, and confusion or behavioral changes. Keep in mind, however, that many urinary tract infections are initially asymptomatic.

Question 52

My patient’s provider ordered a wound culture, but the patient has multiple wounds that are quite large. How do I decide where to collect the specimen from?

Answer 52

Large wounds and multiple wounds call for multiple samples. Never use the same swab on more than one location. Avoid swabbing a wound’s edges because they may be contaminated with external skin flora. Swabbing the center of the wound, parts of the wound with different appearances, and individual wounds will help create the clearest clinical picture in the laboratory.

Question 53

My patient is having difficulty generating a sputum sample for analysis. How can I help her produce a sample?

Answer 53

Teaching the patient to deep breathe and cough may help loosen and mobilize her secretions. Chest physiotherapy is also recommended as an intervention that may help loosen secretions deep in the chest. Try to obtain sputum samples early in the morning before the patient eats or drinks anything. If she tires from attempting to produce a sample, let her rest and return in a short time to ask her to try again. If the patient has a pain-control issue with coughing, pre-medicate her for pain as prescribed at least 20 minutes before asking her to cough and deep breathe to produce a sample. Be sure the client is coughing up sputum and not spitting saliva from clearing their throat.

Question 54

My patient has a nasogastric feeding tube in place. What should the pH be if the tube is placed correctly in the stomach?

Answer 54

Gastric pH should be more acidic than secretions from other areas of the body, which are generally below 5.5. By checking gastric secretions, you can verify both the placement of the nasogastric (NG) tube and the relative rate of gastric emptying (by measuring the residual volume of gastric contents). NG tube placement is initially confirmed by chest x-ray; this is the most reliable method for checking placement. Second only to x-ray, pH testing is considered a reliable method for confirming NG tube placement in the stomach.

Question 55

What instructions should I give a patient who is being sent home with fecal occult blood test (FOBT) cards?

Answer 55

Make sure your patient has three FOBT cards. Tell him to collect samples from three separate bowel movements that are not contaminated with urine. Tell him to use the small wooden stick in the test kit to collect fecal samples and place them in the two windows on the card. Once the samples are in place, he can close the window over the card and label each card with the date and time of collection. Remind him to put his name and date of birth on the cards and to return them within 3 to 14 days of obtaining the sample. Suggest that he avoid red meats, poultry, fish, and certain raw fruits and vegetables, including radishes, turnips, and melons, for 3 days prior to testing and during the testing period, as these can lead to false-positive results, and to increase his water and fiber intake for a few days prior to testing. The patient should also avoid NSAIDs or discontinue NSAIDs or warfarin for 1 week prior to testing per the health care provider’s prescription. Remind him that the test is meant to look for occult blood, which means that even if he does not see blood in his stool, it might still have blood in it.

Question 56

A nursing assistant collected a clena-catch urine specimen from my patient for laboratory urinalysis. By the time I got to the specimen to send it, an hour had passed since it was collected. Can I still send this sample to the laboratory?

Answer 56

Fresh urine samples for laboratory analysis should be placed immediately into a sterile container for transport. They should be kept on ice and transported to the laboratory within 2 hours of collection. Urine that is standing unrefrigerated can become more alkaline, and that can encourage bacterial growth and reduce the validity of the results. This sample was not placed on ice, so you should discard it and start over.

Question 57

My 4- year old patient is afraid of needles. How can I reduce her anxiety while also obtaining an adequate blood sample for her prescribed tests?

Answer 57

Apply a topical anesthetic cream as directed to the area you select for the venipuncture. Use the smallest size needle available for collecting the required amount of blood. Butterfly needles are quite small; you can use them to access the smaller veins in the hands, for example. Some facilities have pediatric child-life specialists who can provide life-size dolls to use when explaining medical procedures. These specialists can show the child what will be done and allow her to play with some of the equipment (modified, of course, for safety) to ease her anxiety.

Question 58

My patient performed a home pregnancy test after missing a menstrual period. She said the test was negative, but a subsequent blood test confirmed that she is pregnant. How should I explain the discrpancy?

Answer 58

Home pregnancy tests are commonly misread, either because the test has expired, it was done too soon after a missed period so the hormone levels were not high enough to show a positive finding, or the sample was collected incorrectly. Many women read the test too soon or wait too long to read the test and end up with false results. Most home pregnancy tests have a very specific window of time between collecting the sample and reading the test. Also, some tests are more sensitive than others to the hormone that indicates pregnancy. For all these reasons, following up with a medical provider to confirm the results is always recommended.

Question 59

I am having difficulty obtaining an adequate fingerstick sample for blood glucose testing for a patient who has diabetes. What should I do?

Answer 59

Since lancets generally come in different sizes for penetrating the skin to different depths, a larger lancet might help. Poor peripheral perfusion can also reduce the availability of blood. Ask the patient to dangle her hands to allow blood to flow into the fingers. Also, ask her to rub her hands together to warm them, as that might promote blood flow. Another option is to wrap the finger in a warm cloth prior to the puncture. Check the skin on her fingers. It might be calloused from repeated fingersticks. If so, try another site, such as the palm of her hand. Do not milk the finger before a fingerstick, though, as this can alter the readings.