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Phlebotomy Ch.14: Lecture 1 (Influence Blood Comp. (diurnal variation…
Phlebotomy Ch.14: Lecture 1
Influence Blood Comp.
age
altitude
dehydration
environment
gender
pregnancy
diet
stress
drugs
exercise
diurnal variation
refers to normal daily fluctuations in the body chemistry related to hormonal cycles, sleep wake cycles, and other changes
Basal state
the body's state after 12 hrs of "fasting" and no strenuous exercise and usually collected early in the morning
changes based on basal state
body position
smoking
Tests and Specimens
Fasting specimen
do not ask pt if they are fasting because they might not know what that means
ask if they have had anything to eat/ drink besides water
ask about caffeine or nicotine use since these both speed up the metabolism
Timed Specimen
used to monitor: medication levels, changes in pt condition, normal diurnal variation in blood levels at different times of day
2 hr Postprandial Test (pp)
used as a screening for diabetes mellitus by comparing a fasting specimen with a specimen collected 2 hrs pp.
collected 2 hrs after eating a meal or ingesting a pre-measured amount of glucose
in norm pt metabolism, 2 hr glucose will have returned to fasting level
Oral Glucose Tolerance Test (OGTT)
used to test for carbohydrate metabolism disorders
Hyperglycemia
elevated blood sugar caused by diabetes- 3 hr test
Hypoglycemia
lower blood sugar due to metabolic disorders- 5 hr test
pt will be on increased carbohydrate diet for several days prior to testing
pt will present in fasting state and have a blood and urine specimen taken and tested for glucose
if glucose is elevated the physician is consulted before proceeding
pt must drink a standardized amount of glucose within 5 min
timing for the test is based on the time the drink is finished
pt given a timetable and encouraged to drink water to stay hydrated
specimens will be collected at 30 min, 1 hr, 2 hr, and 3 hr
Epinephrine tolerance
determines the pt's ability to mobilize glycogen from the liver after given a dose of epinephrine
Glucagon Tolerance
identical to the epinephrine test except a dose of glucagon is given
Lactose tolerance
determines whether the lactose digesting enzyme, lactase, is present in the gut
Therapeutic Drug Monitoring(TDM)
used to maintain constant therapeutic plasma drug levels and ensure that the drug dose does not reach toxic levels
collections are used to coincide with the trough and peak levels of the drug
the trough level is the lowest level of drug and collected just before a dose is given (usual is 30 min)
peak level is the highest level of the drug and collected at a time after a dose is given
Blood Culture (BC)
draw stat or timed to test for presence of microorganisms, septicemia, in blood which have caused fever of unknown origin, FUO
most critical part of procedure is aseptic collection technique to prevent a false positive BC
collections may be timed to coincide with a temp. spike or prior to antibiotic dose
recommend collection is to collect from two different sites, to rule out skin contam with a second pair following the first pair by 30 minutes.
each pair consists of an anaerobic and aerobic bottle