Chapter 12- Specimen Handling and Procurement

Give patient instruction card and read the instructions to them. Ask them if they understand. If they are confused take the time to explain and even re-explain to them what the instruction card says.

What is the proper way to educate the patient on what to do and what not to do before specimen collection?

Fasting (nothing by mouth) and refraining from strenuous exercise for 8-12 hours before the blood draw.

What does “basal state” refer to?

SST.

What tube does a lipid panel go in?

After a meal.

What does postprandial mean?

Will a lab still let you proceed with a blood draw if the patient has not fasted

After a meal.

What does postprandial mean?

Some labs will allow the draw.

Will labs allow a fasting draw to still be taken?

Note on the requisition form that the patient was not fasting.

What should you do if you draw a patient who is supposed to but did not fast?

To measure blood levels of substances exhibiting diurnal, to monitor changes in patient condition, and to determine levels of medication in the bloodstream.

What are some examples of why you would need a timed specimen?

To verify that your patient has followed the guidelines.

What is your responsibility as a phlebotomist?

To observe the blood levels of certain medications to ensure patient safety and maintain a therapeutic plasma level.

What is therapeutic drug monitoring?

Trough & Peak

What should blood be drawn to coincide with?

15 minutes before the scheduled dose.

When are trough levels collected?

The medication, patient’s metabolism, and route of administration.

What does the time for collecting peak levels depend on?

The time of the last dose of medication.

What does the lab need to know when drawing for therapeutic drug monitoring?

Dividing a whole sample into parts.

What is aliquoting.

Incubator or chemical hand warmers.

What can you use to prewarm a tube?

30 minutes

How long do you warm a prewarmed tube?

37c

What temperature do you heat a prewarmed tube at?

Antibodies produces in response to mycoplasma pneumonia infection.

What are cold agglutinins?

Red top

What color tube are warmed specimens collected in?

Immediately

When handling chilled specimens, how soon do you need to chill after collection?

Separation

What does chilling the sample prevent?

Have a “mold” of the tube ready with aluminum foil, place the tube in the mold after collection and place sample in a brown or amber colored bag

How should you protect light sensitive samples?

Ammonia, lactic acid, ABG, gastrin, glucagon, parathyroid hormone, PTT, PT

What are common specimens that need chilling?

Cryoglobulin, cryofibrinogen, cold agglutinin

What are common specimens that need warm collection & transportation?

Bilirubin, vitamin B12, urine porphyrins, carotene, red cell, folate serum, folate, vitamin B6

What are some common specimens that require protection from light?

Lactic acid

What specimen must be drawn without stasis (without tourniquet)?