Ensuring that appropriate clinical laboratory tests are ordered Procuring clinical laboratory test samples in an efficient timely manner Producing accurate clinical laboratory test results Correlating and interpreting clinical laboratory test data ID: 779366
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Slide1
Medical Laboratory
Slide2Quality clinical laboratory testing is evidenced by: performing the correct test, on the right person, at the right time, producing accurate test results, with the best outcome, in the most cost-effective manner. This is accomplished by:
Ensuring that appropriate clinical laboratory tests are ordered;
Procuring clinical laboratory test samples in an efficient, timely manner;
Producing accurate clinical laboratory test results;
Correlating and interpreting clinical laboratory test data;
Disseminating clinical laboratory test information to clinicians and patients in a timely manner;
Evaluating the outcome of clinical laboratory testing for each individual patient and the entire health care system;
Utilizing qualified medical laboratory personnel.
Slide3Obtaining Blood Glucose
Record & Report
Fasting BS: Before the patient has had anything to eat/drink.
PPBS: 2 hr postprandial blood sugar is collected exactly 2 hrs after the patient finishes eating.
The patients BS should return to normal within 2 hrs.
Specimens that are not collected at the proper time can cause misinterpretation of the results. (report all results to the RN)
STAT BS: BS must be checked immediately.
Slide4Obtaining Blood Glucose
Record & Report
Fingerstick
Blood Sugar: FSBS is checked by collecting a sample of capillary blood with a lancet. This is transferred to a reagent strip or other test strip.
Slide5Obtaining Blood Glucose
Record & Report
Important observations of diabetic patients
Inadequate food intake
Eating food not allowed on diet
Refusal of meals, supplements, or snacks
Inadequate fluid intake
Excessive activity
Complaints of dizziness, shakiness, racing heart
Blood sugar values outside of normal reporting range for your facility
Slide6Hyperglycemia
Nausea, vomiting
Weakness
Headache
Full, bounding pulse
Fruity smell to breath
Hot, dry, flushed skin
Labored respirations
Drowsiness
Mental confusion
Unconsciousness
Sugar in the urine
High blood sugar as measured by FSBS
Slide7Hypoglycemia
Complaints of hunger, weakness, dizziness
Shakiness
Skin cold, moist, clammy, pale
Rapid, shallow respirations
Nervousness and excitement
Rapid pulse
Unconsciousness
No sugar in urine
Low blood sugar as measured by FSBS
Slide8FSBS
Need:
Gloves
Alcohol sponge
Lancet
Blood glucose meter
Reagent strip or test strip
Sharps container
Plastic bag for used supplies
Wipe patients finger with alcohol, allow to dry
Pierce the side of the middle or ring finger using lancet
Discard lancet
Squeeze finger gently to obtain drop of blood
Hold site directly over test strip
Wipe patients finger with alcohol and apply pressure
Slide9A1C
Measurement of glucose levels in the blood over a prolonged period of time. It differs from the
fingerstick
blood sugar because it provides a snapshot of the patient’s diabetic control over the past 2 to 3
mths
. The % of A1C in whole blood is
50% from the most recent 30 days
25% from the previous 30-60 days
25% from the previous 60-90 days
Normal (non-diabetic) A1C = 5%
ADA recommended goal < 7%
In some facilities, a value above 6.5% is further addressed
Slide10A1C
Slide11A1C
Slide12Urine
Physical testing of urine includes:
Color
Odor
Transparency
Specific gravity
Physical characteristics normal/abnormal
Slide13Collecting a Urine Sample
(documentation)
Urine Specimen used for a variety of laboratory tests such as urinalysis.
Usually collect the first urine voided in the morning because this urine is more concentrated and may reveal more abnormalities. Also usually has an acidic pH which helps preserve any cells.
Specimen can be collected in:
Bedpan, urinal, specimen hat, specimen cup
Usually 120mL is sufficient (if unable to produce that amount send what is collected to lab anyway)
Slide14Collecting a Urine Sample
(documentation)
Midstream (clean-catch) Specimen: a urine specimen that is free from contamination. Because microorganisms are present on the genital area and on the specimen containers, special precaution are used to obtain a specimen.
Genital area will be cleansed thoroughly
Female: front to back motion, external lip, internal lip, then center.
Male: Circular motion from
meatus
down
Slide15Midstream specimen
Slide16Obtaining a Sterile Specimen
Slide1724 Hr Urine Sample
The first urine voided in a 24-hr specimen is discarded because it was produced before the start of the test.
Preserving a 24-hr specimen can be done by cold storage or chemicals.
Slide18Collecting a Stool Sample
(Documentation)
It is important to send a sample being examined for ova and parasites to the lab immediately because it is most accurate within 30 minutes and it should stay at body temperature.
When an occult blood test is positive it indicates there is blood present in the stool.
All urine and stool specimens should be placed in a biohazard bag when transported to avoid contamination from spills.
Slide19Proper Procedure for
Capillary Blood Test
Slide20Basic Technique for
Venipuncture