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Phleb Handbk Ch15

Special Collection

Blood cultures aid identifying bacterial organism causing infection
Blood cultures collected by ? technique on patients with ? aseptic, fevers of unknown origin
bacteremia bacteria in blood
septicemia "sepsis", inflammatory immune response due to bacteria in blood, usually fatal
septicemia signs fever, high heart rate, low bp, rapid breathing>>shock
Important differences vs. venipuncture greater detail in patient procedure instructions: more blood, 2 venip, "tubes" diff
Interfering factors: antibiotics collect before antibiotics. resin beads (charcoal) neutralize by mixing
Blood culture ? in order of draw to first. avoid needle contamination
fill ? bottle 1st b/c anaerobic. bacteria>>exposure to air>>die>>false neg result
Best practice to ? from indwelling IV catheter NOT draw
? palpate sterile site do NOT repalpate sterile site
If must repalpate wear sterile gloves, above/below puncture site
iodine tincture swab allergic chlorhex or <2 mos old
chlorprep contains chlorhexidine gluconate and alc
blood culture draw - ask patient before procedure allergies to antiseptics?
70% alc prep = ? sec 60 sec using circles (rids surface dirt)
chlorhexidine gluconate = ? sec 30 sec using circles
chloraprep = ? sec 30 sec scrubbing back/forth
airdry = ? sec 60 sec
no chloraprep for <2 mos old
collection methods syringe, butterfly, evac tube holder (SPS only)
sterile cap removed>> cleanse top with 70% alc
? mL blood per bottle for adult? 10 mL
<3mL or extra collected>>>> aerobic
? mL pediatric blood culture bottle 1-5 mL
If iodine used remove from skin, clean with alc
? push plunger NEVER
Dr. Amy's preferred collection method Butterfly with syringe
GTT diagnostic tool, for carb metabolism prob people
GTT patient instructions Illness last 2 weeks? Normal, bal meals 3 days prior? Fast 8-12 hours? No smoke, tobacco, gum, mint, candy! No exercise, stay ambulatory (walk/rest)!
Water? Ok
Glucose drink contains ? grams 75 grams
postprandial "after meal"
postprandial is 2 hr test. used to screen diabetes mellitus/gestational
2 hr test idea glucose level should lower 2 hours after meal
Modified oral GTT variation of postprandial GTT. Fasting glucose level collected>>75 gram drink with time noted>>glucose level check 2 hrs later
lactose milk and sugar
lactase enyzme breaks lactose>> glucose + galactose
lactose symptoms diarrhea, abd pain, bloating
Lactose tolerance invasive method lactose drink, plasma glucose level checks, not digested>>low glucose
Why glucose in lactose test Lactose>> glucose + galactose
Lactose noninvasive method breath hydrogen measured. used to diagnose lactase enzyme deficiency
ABG from ? artery radial first
ABG provides useful info about respiratory status and acid-base bal
Therapeutic drug monitoring (TDM) used to monitor serum concentration of certain drugs
TDM requires coordination timing important
trough vs. peak lowest concentration of drug in patient's serum vs. highest
genetic molecular test in ? tube Lavender.
cytogenetic test in ? tube green: sodium heparin
Genetic material is only viable for ? 6-24 hours
fistula artificial shunt, vein + artery fused through surgery for dialysis, do not collect! strong "buzzing" pulse
cannula tubular instrument to access vein for dialysis
autologous transfusion blood donation before surgery>>given to themselves, safest blood is your own, eliminates the possibility of antibodies forming when transfused
therapeutic phlebotomy intentional removal of blood for therapeutic reasons, excessive blood cell production