Specimen Collection

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During a specimen collections what are the nurses responsibilities?

for assessing the patients knowledge of and preparing the patient for the procedure, assisting the physician with the procedure, and caring for the patient after tests are completed.

what is an informed consent?

the patient or a family member of the patient that is legally responsible for he or she fully understands what will be done during a test, surgery, or any medical procedure and understands its risks and implications before legally consenting to it.

what factor can make it difficult to collect a specimen for blood glucose determination in an older adult?

decreased peripheral circulation

when labeling a speciemen container what must be included?

patients: name, age, room number, physician, date and time, type of specimen, and collector's initials

What are the general guidelines for diagnostic examination?

know the patients baseline vital signs, know the patients level of education, determine the patients awareness of actual of potential medical diagnosis, perform a thorough nursing assessment, determine the patients previous experience with diagnostic testing, know normal values of the test being performed.

what are possible allergic reactions to iodine dye?

mild flushing, itching, and urticaria to severe.

what is anaphylaxis?

an exaggerated life threatening hypersensitive reaction to a previous encountered antigen; evidenced by respiratory distress, drop in blood pressure, or shock.

what medications are given during an anaphylatic reaction?

benadryl, steroids, epineprine

what are delayed reactions to the iodine dye after an X-ray?

dyspena, rashes, tachycardia, hives.

when do delayed reactions to the iodine dye occur after the X-ray?

2-6 hours

Nursing interventions: abdominal exam (pre)

-instruct patient to be NPO for 4 hours.
-assess patient for allergies to dye of shellfish

Nursing interventions: Amniocentesis (pre)

-monitor fetal heart tones
-before 20 weeks of gestation, it is necessary to keep the bladder full to support the uterus
-after 20 weeks, the bladder is typically emptied to minimize the chance of puncture

after an amniocentesis what should a nurse do?

monitor the fetal heart tones

after an amniocentesis and a patient complains of vertigo or nausea what should a nurse do?

allow her to rest on her left side for several minutes before leaving the examination room

what are the pre examination nursing interventions for an arteriography?

-assess allergies to dye
-assess if patient has been taking anticogulants
-keep patient NPO for 2-8 hours

what are the pre examination nursing interventions for a Barium enema?

-clear liquid for lunch and supper (no dairy products)
-have patient drink of glass of water or clear liquid every hour for 8-10 hours.

what are some post examination nursing interventions for a Barium Swallow?

-inform the patient of the need to evacuate all of the barium
-advise patient that at first their stills will be white

before a bone scan what two things should you reassure the patient about?

-that they will not be exposed to large amounts of radioactivity because only tracer doses of the isotope are used
-inform patients that they will hear a clicking noise as the scanner moves

after a bone scan what should be observed and for what?

observe injection site for erythema or edema.

what should the nurse obtain from a patient before a bronchospy?

informed consent before patient is premedicated

before a bronchoscopy how long should a patient be NPO?

after midnight for 4-8 hours

what should you now all the patient to do after a bronchoscopy?

to eat or drink after procedure until no effects of anesthesia remain and gag reflex has returned

what should you reassure to a patient before a bronchoscopy?

that they will be able to breathe

what should you make sure about a patients hair before an electroencephalogram?

the hair is clean, adiminster shampoo, don't use any oils, sprays, or lotions

what should you not administer to patient before an electroencephalogram?

sedatives or hypnotics, unless ordered

what should you encourage intake of to a patient before (EEG) but eliminate what?

intake of food but eliminate coffee, tea, colas

How long should you keep a patient NPO before the exercise tolerance test?

for 4 hours, except for water, unless medications are ordered

when should you administer the iopanic acid tablets during a gallbladder series or cholecystogram?

the day before the examination, early in the morning

how many mintues between each intake of pill should there be for a gallbladder seires?

15 mintues.

how long should you keep a patient NPO before a glucose tolerance test?

for 12 hours

what should you assess for in a patient before a liver biopsy?

assess for blood cogulation profile, essential that is normal

how long should you keep a patient NPO for?

keep patient NPO after midnight

how long should you wait to take the liver biopsy to the lab?

don't wait, do it STAT

after liver biopsy how long should patient be on bed rest?

for 24 hours

what side should patient lay on after liver biopsy?

on right side for 1-2hours

what should a patient avoid after a liver biopsy?

coughing or straining

how long should a patient avoid stranious activites after a liver biopsy?

1-2 weeks

define specimen:

a small sample of something, intended tos how the nature of the whole

`what is the most common diagnostic test?

urine analysis

why is urine tested?

determinations of pH, protein, glucose, ketones, blood, and specfic gravity.

how do you obtain a sterile urine sample?

by either inserting a catheter into the urniary bladder and remove urine, or obtain a specimen from the port of an indwelling catheter using sterile technique.

what is residual urine?

urine left in the bladder after voiding

to collect residual urine, how many minutes to you wait after the patient has voided to insert the catheter?

10 minutes

how much urine is considered residual urine?

more than 50 ML

when collecting sterile urine from a catheter port, what do you do?

clamp just below catheter port for about 30 minutes

what should you have the patient do before collecting a 24 hour urine specimen?

have patient void just before collection begins

what does it mean when stool is black and tarry?

bleeding is occuring higher in the GI tract

what does it mean when stool has bright red blood?

bleeding is occuring lower in the GI tract

what does occult mean?

when blood is present in the stool but you are not able to see it without the use of a microscope

what does hemoccult mean?

a test the detects occult blood in feces

what does culture mean?

a lab test involving cultivation of microorganisms or cells in a special growth medium

what does sensitivity mean?

a lab method of determining the effectiveness of antibiotics usually performed in conjunction with culture.

what does expectorate mean?

eject mucus, sputum, of fluids from trachea and lungs by coughing or spitting

what does suctioning of sputum stimulate?

of vagal nerve fibers

what is the result of stimulated nerve fibers during suctioning of sputum collection?

results in cardiac dysrhythmias and increased intracranial pressure.

is it okay to collect wound samples from old drainage? why or why not?

no because resident colonies of bacteria grow in exudate

define Aerobic organismis:

grow in superficial wounds exposed to the air

define Anerobic organisms:

tend to grow within the body cavities

how do you collect an aerobic specimen?

with a sterile swab

how do you collect an anerobic specimen?

with a sterile syringe

what should you assess the patient for during a would culture?

for fever, chills malaise, elevated while blood count,

if a patient required an analgesic before dressing change, it is ideal to give this medication how long before dressing?

30 minutes

what does MRSA stand for?

staphylococcus aureus

when collecting nose and throat specimnes what condition should you assess?

the condition of the pharynx

during a throat specimen what do you do when the pharynx is not visulazed?

depress tounge with tounge blade and note inflamed areas of pharynx or tosils.

what is venipunture?

involves inserting a hallow bore needle into the lumen of a large vein to obtain a specimen

what is an acutanier tube?

a tube that allows the drawing of mulitple blood samples

during a venipunture what blood flow does a tourniquet prevent?

arterial blood flow, and prevents venous blood from returning to the heart

when tourniquet is used for blood draws what blood flow does it prevent?

nor arterial blood flow

what are the two most common venupunture sites

the cephalic site, and basilic site

how long should a tourniquet be kept on a patient

no longer than 1-2 minutes

what is an electrocardiogram

is a graphic representation of electrical impulses generated by the hear during a cardiac cycle.

what abnormalities does an EKG identify?

the abnormalities that interfere with electrical conduction through cardiac tissue

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