Mod 3 - Pt Preparation Flashcards
what should be on the lab requisition form
- pt full name
- pt DOB
- pt sex
- specific identification/medical record number
- tests ordered
in addition to the most basic info, what may be on the lab requisition form
- specific precautions/concerns
- date & time of collection
- billing info
- diagnostic coding
- specific preparations/restrictions prior collection
- priority
define FASTING
not eating or drinking anything except water for generally 8-12 hours
define BASAL STATE
condition of rest and fasting for at least 12 hours and typically in the morning upon waking
if a facility does not use pt labels, what should be recorded on the blood tubes
- date & time of collection
- your initials
- pt full name & DOB
- other specific indicators
the timing of an individual’s basal state is based on when they
wake up
what questions should be asked before venipuncture
- any allergies (specifically latex)
- have you eaten/drinken anything
- have you taken any medications
- do you faint at the sight of blood
- arm preference
what should be done when a pt feels faint
- stop procedure
- have pt lower head & take deep breaths
- loosen any tight clothing around the enck
- apply a cold compress on forehead or back of neck
how long should be a pt be observed for if they faint/feel faint
15 min
what can be done when anticipating for a fainting episode
lock arm of phlebotomy chair
acetaminophen can falsely
elevate levels of liver enzymes
some blood pressure meds can affect
glucose, sodium, and potassium levels
how can alcohol affect blood results
affect coagulation activation and platelet reactivity
alcohol can affect coagulation activation and platelet reactivity especially in pts with
diabetes mellitus
t/f: chewing gum can affect fasting blood results
true
the effects of smoking on blood are
elevation of several coagulation factors
vigorous exercise can cause
coagulation activation
how long should a pt rest before venipuncture if they exercised recently
15-30 min
what are some complications of venipunctures
- excessive bleeding/bruising
- hematoma
- severe pain/lack of sensation
- infection
what should be done if gauze becomes soaked with blood after venipuncture
apply pressure and ice until pt further evaluated by provider
if a pt experiences severe pain, numbness, or tingling in the venipuncture arm, this may indicate
nerve damage
what may be used when the nerve was accidentally hit during a venipuncture but depends on facility policy
ice
t/f: hematomas can evolve info infections
true
hematomas may be referred to as
bruises
which vein has a higher incidence of nerve involvement
basilic vein
why are ankle and foot veins the last choice veins
difficult to access, easy to injure, often painful
blood should never be collected from the ankle/foot if the pt has
diabetes mellitus or peripheral vascular disease
what should be done if a vein cannot be palpated
have them place the arm below the heart
when an IV is involved, where should the blood be drawn
above catheter insertion site
blood should not be drawn from an arm that has ____ bc it can compromise circulation and damage it
arteriovenous fistula/shunt for hemodialysis
blood should not be drawn from an arm that has ___ bc it can be damaged
central venous access device
blood should not be drawn from arm on the same side as a recent ____ bc it can cause swelling, injury, or infection
mastectomy
blood should not be drawn from a site that has ___ bc it can alter test results and be painful
edema
blood should not be drawn from a site with ___ bc it will be difficult and painful
scarring
blood should not be drawn from a site that has __ bc it can alter test results, be painful, increase risk of nerve damage, or cause permanent damage to circulation
hematoma
what veins are poor candidates for venipuncture
sclerotic, thrombotic, phlebitic, fragile, tortuous
define SCLEROTIC VEINS
hard, inflexible, and narrow veins
why are sclerotic veins poor candidates
difficult to puncture and painful
cause of sclerotic veins
aging and constant blood draws on same site
aka TORTUOUS VEINS
varicose veins
why are tortuous veins poor candidates
easy to push needle completely through vein wall
why are fragile veins poor candidates
painful and generally needs multiple sticks to collect enough blood
define FRAGILE VEINS
thin, weak, and difficult to puncture; they collapse easily on palpation and don’t refill quickly
fragile veins are common in
elderly, newborn, and peds pts
define PHLEBITIC VEINS
tender and warm veins with red area and may have clots
why are phlebitic veins poor candidates
difficult to puncture and painful
infants younger than ___ should have a capillary heel stick
12 months
when doing an infant heel stick, never use a lancet that punctures deeper than
2 mm
generally how much urine is enough for a random urine testing
30-60 mL
urine begins to deteriorate within ___ of collection
30 min
what are instructions for clean-catch urine for men
- don’t let anything besides urine tough the lid/inside of cup
- wash hands
- retract foreskin and clean meatus in a circular outward motion
- pee a little in toilet then into the cup and then finish in the toilet
what are the instructions for a clean-catch urine for women
- don’t let anything besides pee touch the inside of cup or lid
- wash hands
- separate labia and wipe with towelettes front to back
- pee a little in toilet, then cup, then in toilet while still holding labia separated
how does a 24 hour urine collection start
begins at specific time by peeing into toilet then recording start time
what may make the 24 hour urine collection invalid
pt pees into toilet at any time during 24 hour period
how should the urine be kept during a 24 hour urine collection
in the refrigerator/on ice
what is the normal range for urine pH
5.5-8
bacteria grows better in
alkaline environments
unrefrigerated urine becomes more
alkaline
specific gravity of urine is usually
1.010-1.025
highly concentrated urine can be a sign of
dehydration
WBC and nitrates in urine indicate
infection
hemoglobin in urine can indicate
bleeding, infection, cancer, kidney disease, chemical poisoning, and other pathology
define KETONES
products of fat metabolism
ketones in urine can signify
diabetes mellitus, starvation, vomiting
bilirubin in urine may signify
liver disease or RBC destruction
protein in urine can signify
inflammation, infection, kidney disease, or chemical poisoning
glucose in urine can signify
diabetes mellitus
stool samples should not be refrigerated if they are being tested for
parasites
what should be avoided when doing a stool sample
contaminating feces with urine or toilet water
what are some pre-testing instructions for fecal occult blood test
- do not eat red meat, citrus, or raw veggies 3 days before collection
- do not take vitamin C or aspirin 3 days before collection
FOBT stands for
fecal occult blood test
when should sputum be collected
in the morning before eating or drinking anything or doing any oral hygiene
what are the instructions for collecting a sputum sample
- take a deep breath
- cough forcefully and deeply and cough up the sputum into the container
- do not spit saliva into the container
- close the lid, clean the outside of the container, put the label on
how much sputum should be in a sample
generally 1-2 teaspoons
semen samples must reach the lab within
1-2 hour of collection
t/f: the pt should avoid mixing or inverting the container after collecting specimen while doing a 24 hour urine collection
false: the container should be gently mixed and inverted after each sample is added
U R COLLECTIG A SPECIMEN TO TEST PT’S LITHIUM LEVEL AFTER RECENT DOSE OF MEDS. WHICH LEVEL SHOULD BE COLLECTED
a) random
b) trough
c) fasting
d) peak
d) peak
what types of urine specimen should be collected for a pregnancy test
first-morning
U R DOING A VENIPUNCTURE ON A PT WITH AN IV IN BOTH ARMS. WHAT SHOULD U DO
a) ask the nurse to turn the IVs off for 1 min
b) apply tourniquet above IV site
c) ask nurse to turn IVs off for 2 min
d) ask nurse to remove 1 IV
c) ask nurse to turn IVs off for 2 min
what statement should the CPT say when prepping to collect a blood sample for a cholesterol test
sit for at least 5 min before the test
