Quality 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.
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Obtaining 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.
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Obtaining 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.
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Obtaining 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
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Hyperglycemia 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
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Hypoglycemia 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
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FSBS 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
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A1C 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 patients 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
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A1C
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Slide 12
Urine Physical testing of urine includes: Color Odor
Transparency Specific gravity Physical characteristics
normal/abnormal
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Collecting 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)
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Collecting 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
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Midstream specimen
Slide 16
Obtaining a Sterile Specimen
Slide 17
24 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.
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Collecting 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.