A phlebotomist has just confirmed critical values on a laboratory test. Which of the following actions should the phlebotomist take when the physician's office is already closed?
Contact the physician by paging or calling right away.
Leave a message at the physician's office number.
Call the physician's office on the next business day.
Fax the results to the physician's office with a stat fax cover.
The Correct Answer is A
Choice A Reason:
Contacting the physician by paging or calling right away is the most appropriate action when critical values are confirmed on a laboratory test. Critical values are defined as those that indicate the patient is in danger of death unless treatment is initiated immediately. Immediate notification of the responsible licensed caregiver is required so that appropriate clinical action can be taken for the patient. This is a standard procedure compliant with CLIA regulation 493.1109(f) and is essential for patient safety.
Choice B Reason:
Leaving a message at the physician's office number is not an adequate response to confirmed critical values. Messages can be overlooked or not checked until the next business day, which could delay necessary urgent medical interventions.
Choice C Reason:
Calling the physician's office on the next business day is not acceptable when dealing with critical values. The urgency of critical results requires immediate action, and waiting until the next business day could result in significant harm or death to the patient.
Choice D Reason:
Faxing the results to the physician's office with a stat fax cover is not sufficient for immediate communication of critical values. While the fax may indicate urgency, there is no guarantee that the fax will be seen immediately by the physician or their staff. Direct communication through paging or calling ensures that the critical information is relayed without delay.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
The Apgar score is a quick test performed on a newborn at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score tells the healthcare provider how well the baby is doing outside the mother's womb. While it is an important indicator of a newborn's health, it does not directly influence the calculation of total blood volume.
Choice B reason:
Height is a measure of the length of a person's body. In the context of a 2-day-old infant, height is not a practical or necessary measurement for determining blood volume. Blood volume is more closely related to weight than to height, especially in the case of infants.
Choice C reason:
Head circumference is a measurement of the size of a child's head and is used to monitor brain growth. While it can provide valuable information about a child's development, it is not used to calculate blood volume. The total blood volume of an infant is not determined by the size of the head but rather by the overall weight.
Choice D reason:
Weight is the correct factor to consider when calculating total blood volume for a full-term, 2-day-old infant. The standard formula to estimate an infant's total blood volume is approximately 80 {mL/kg} of body weight. Therefore, knowing the infant's weight in kilograms is essential for this calculation.
Correct Answer is B
Explanation
Choice A Reason:
Prepping the site with povidone iodine is not typically associated with hemoconcentration. Povidone iodine is used as an antiseptic to clean the skin before venipuncture to prevent infection. While it's important to allow it to dry to avoid sample contamination, it does not cause hemoconcentration.
Choice B Reason:
Leaving the tourniquet in place for more than 2 minutes can lead to hemoconcentration. A tourniquet is applied to engorge the veins, making them easier to puncture. However, prolonged application can result in fluid being forced out of the vein into the tissue, increasing the concentration of cells and larger molecules in the blood. This can affect certain laboratory test results by artificially increasing the levels of cellular components.
Choice C Reason:
Not refrigerating the specimen within 30 minutes does not cause hemoconcentration. However, it can affect the stability of certain analytes in the blood sample. Refrigeration is necessary for preserving the integrity of certain components of the blood until analysis, but it is unrelated to the concentration of cells within the sample at the time of collection.
Choice D Reason:
Removing the needle before the tourniquet is released does not cause hemoconcentration. This action might lead to other complications, such as hematoma formation, but it does not affect the concentration of cellular elements in the collected sample.
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