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16 Cards in this Set

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common specimens
BLOOD:
Glucose
Cultures

URINE:
Routine
Mid-stream or “clean catch”
Sterile

STOOL
NOSE/THROAT
SPUTUM
WOUND
Nursing responsibilities: specimen collection
Provide patient comfort, privacy and safety
Provide education
Purpose of specimen collection
Patient preparation
Use correct procedure to collect specimens
OSHA standards
Hospital Guidelines
Correct labeling, storage and transportation
Reporting results to primary care provider
2013 National Patient Safety Goal
Type I Diabetes
Beta cells of pancreas don’t produce insulin
10% of diabetes diagnoses
Was called “IDDM” or insulin dependent diabetes mellitus
ALWAYS requires insulin

Treatment: includes taking insulin and possibly another diabetic medicine, making wise food choices, and being physically active.
Type II Diabetes
Beta cells make insulin but body cells are resistant to the insulin produced
90% of diabetes diagnoses
Was called “NIDDM” or non-insulin dependent diabetes mellitus
Treated with oral hypoglycemic agents, insulin or a combination of both

Treatment: includes using diabetes medicines, making wise food choices, being physically active and losing weight.
Gestational diabetes
diabetes developed during the late stages of pregnancy. Although this form of diabetes usually goes away after the baby is born, a woman who has had it is more likely to develop type 2 diabetes later in life. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin.
normal fasting blood sugar
normal fasting blood sugar is generally between 70 and 100. A level over 126 often means diabetes and requires further testing such as a glucose tolerance test.
capillary blood glucose
Calibrate machine.

Determine if fasting, before meals, or after meals

Is insulin scheduled, prn, or per carbohydrates ingested?

Is patient on medications that may prolong bleeding

Assess for signs/symptoms of hypo- or hyperglycemia

Know agency/facility protocol to follow for hypoglycemia

Understand various types of insulin, onset, peak and duration

Know normal glucose values (may be agency specific)
Slightly higher 1-3 hrs after ingesting meal
Hgb A1c should be between 4%-5.6% in non-diabetics
Hgb A1c test for diabetics
6.5% or higher indicate diabetes. Because studies have repeatedly shown that out-of-control diabetes results in complications from the disease, the goal for people with diabetes is a hemoglobin A1c less than 7%. The higher the hemoglobin A1c, the higher the risks of developing complications related to diabetes. This test looks at glucose control over a longer period of time for the patient.
hypoglycemic symptoms
Shaky
tachycardia
sweating
dizziness
Anxiousness
hunger
blurred vision
weakness
fatigue
Head Ache
irritablility
hyperglycemic symptoms
Extreme thirst
urinating often
dry skin
hunger
blurred vision
drowsiness
slow healing of wounds
life span considerations for glucose test
Sites:
Heel - Neonate and infants to age 2
Side of fingertip - Over age 2 through adult.
Earlobe – hypovolemic or edematous patients.
Infants:
Warm pack heel before heel stick
Children:
Let child choose which finger to use when possible
Reassure child is not a punishment
Elderly:
Warm hands prior to fingerstick
blood tests
Blood tests
Aid in diagnosis
Obtained by:
Skin puncture
Venipuncture
Arterial puncture

Blood cultures
Detect bacteria in blood
Require two specimens from two different sites
Obtain before antibiotics are started
lab values of urine
pH
4.6-8.0
Specific gravity
1.010-1.025
Protein
negative
Glucose
negative
Ketones
negative
Blood
negative
stool collection
Performed to:
Analyze GI function
Steatorrhea (fat)
Digestive secretions
Infections
Bacteria
Viruses
Presence of ova and parasites
Bleeding in the GI tract
stool collection
Wash hands
Apply gloves
Have patient void before specimen collection (to prevent contamination)
Use 1 or 2 tongue blades to transfer stool to container
1 inch for formed stool
15-30 cc for liquid stool
Include visible blood, pus, or mucous
Label and transport in biohazard bag
May need to be refrigerated
sputum collection
Determine need for PPE
Assist to sitting position for maximum lung expansion
Need 1-2 tsp (or 5-10cc) of sputum for analysis

Cover specimen container after collection to prevent spread of microorganisms
Reassess patient condition after collection
Assist to rinse mouth with mouthwash after collection prn
Document color, consistency, odor, volume, viscosity and/or presence of blood in specimen