A patient who is on droplet precautions requires daily blood glucose monitoring. Besides gloves, which piece of personal protective equipment must the phlebotomist wear when drawing the sample?

Choice A Reason:
The right antecubital fossa is not the optimal site for blood collection in this case because the presence of a shunt in the right forearm can complicate the procedure and potentially damage the shunt, which is a critical access point for dialysis treatments.

Choice B Reason:
The right hand should also be avoided for blood collection due to the shunt placement in the right forearm. Using the same arm as the shunt for venipuncture could lead to complications such as infection, clotting, or accidental damage to the shunt.

Choice C Reason:
The left antecubital fossa might seem like a viable option; however, with an IV placed in the left hand, it is generally recommended to avoid using the same limb for blood collection to prevent contamination of the sample and reduce the risk of infection at the IV site.

Choice D Reason:
Capillary collection from the left hand is the most appropriate choice in this scenario. It avoids the arm with the shunt and the IV, reducing the risk of complications. Capillary blood collection is a suitable alternative when venipuncture sites are limited, and it can provide an adequate sample for a CBC.

Choice A reason:
Glucose and triglyceride levels are influenced by recent food intake, so it is essential to measure these levels after a period of fasting to obtain accurate results. Fasting ensures that the glucose measurement reflects the body's baseline glucose level without the influence of a recent meal, which is crucial for diagnosing and managing conditions like diabetes. Similarly, triglycerides, which are fats in the blood, can be elevated after eating, so a fasting sample gives a clear picture of the lipid profile for assessing cardiovascular risk.

Choice B reason:
While BUN (Blood Urea Nitrogen) levels can be affected by diet, fasting is not typically required for BUN or alkaline phosphatase tests. These tests are often part of a comprehensive metabolic panel that may or may not require fasting. However, fasting is not specifically necessary for accurate measurement of these two tests.

Choice C reason:
Creatinine and total protein levels are generally not affected by short-term dietary intake, so fasting is not required for these tests. Creatinine is a waste product from muscle metabolism and is used to evaluate kidney function, while total protein levels can indicate a variety of conditions including liver and kidney disorders, but they reflect the body's long-term nutritional status rather than immediate food intake.

Choice D reason:
Lactate dehydrogenase (LDH) and albumin tests do not require fasting. LDH is an enzyme found in almost all body tissues and is released into the bloodstream when tissues are damaged, so its levels are not dependent on food intake. Albumin is the most abundant protein in the blood and is produced by the liver; its levels are used to assess liver and kidney function, nutritional status, and other conditions, but fasting is not necessary for accurate measurement.