A phlebotomist is preparing to draw blood from a patient for therapeutic drug monitoring. Which of the following questions should the phlebotomist ask?
"When was your last dose of lithium?"
"For how long have you been fasting?"
"When did you have your last alcoholic beverage?"
"Have you finished drinking the glucose solution?"
The Correct Answer is A
Choice A Reason:
Asking "When was your last dose of lithium?" is crucial for therapeutic drug monitoring (TDM). TDM is used to tailor dosages and maintain therapeutic levels in a patient’s bloodstream, especially for drugs with narrow therapeutic indices like lithium. The timing of the last dose can significantly affect blood levels, and knowing this information helps in interpreting the results accurately.
Choice B Reason:
While knowing the fasting status of a patient may be relevant for certain tests, it is not typically critical for TDM unless the medication being monitored is affected by food intake. Lithium levels are not significantly influenced by fasting, so this question is less relevant than knowing the timing of the last dose.
Choice C Reason:
Inquiring about the last alcoholic beverage is important if alcohol could interfere with the medication's metabolism or the test's accuracy. However, for lithium TDM, alcohol consumption is not as directly relevant as the timing of the last dose. Alcohol does not typically alter lithium levels unless it affects the patient's hydration status.
Choice D Reason:
Asking if the patient has finished drinking the glucose solution would be pertinent if conducting a glucose tolerance test. However, this is not relevant for TDM of lithium, as the glucose solution does not interfere with lithium levels or the TDM process.
In conclusion, for therapeutic drug monitoring, particularly for lithium, the most critical question is regarding the timing of the last dose. This information is essential to ensure that the blood levels reflect the peak or trough concentration, depending on what is being measured, and to avoid misinterpretation that could lead to inappropriate dosing adjustments.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
A hair cap is used to prevent contamination from the hair, but it is not specifically designed to protect against body fluid splashes. While it is a part of personal protective equipment (PPE), it does not provide coverage for the areas most likely to be exposed to splashes during phlebotomy procedures.
Choice B reason:
A gown is the appropriate choice for protection against body fluid splashes. It covers a significant portion of the body and is designed to prevent fluids from reaching the phlebotomist's skin or undergarments, which is essential when there is a risk of splashes during procedures like venipuncture.
Choice C reason:
Shoe covers protect the feet from contamination, but they are not typically necessary for phlebotomy unless there is a significant risk of large fluid spills on the floor. They are more commonly used in operating rooms or during the cleaning of large spills.
Choice D reason:
Sterile gloves are a standard requirement for phlebotomy to maintain aseptic technique and prevent contamination. However, gloves alone do not provide sufficient protection against body fluid splashes that may reach other parts of the body.
Correct Answer is D
Explanation
Choice A reason:
Gastrin is a hormone that stimulates the secretion of gastric acid by the stomach. While it is a critical component in the digestive process, gastrin is not typically sensitive to light, and therefore, does not require protection from light during handling and transportation.
Choice B reason:
Ammonia testing involves measuring the amount of ammonia in the blood, which can indicate liver function and is used in the diagnosis of hepatic encephalopathy. Ammonia levels are not generally affected by light; thus, special precautions to protect from light are not necessary.
Choice C reason:
Pyruvate is a key intermediate in several metabolic pathways throughout the cell. Pyruvate itself is not considered photosensitive, and standard precautions for handling and transportation are sufficient to maintain its integrity.
Choice D reason:
Bilirubin is a breakdown product of red blood cells and is measured to evaluate liver function and to assess jaundice. Bilirubin is known to be photosensitive; exposure to light can cause it to break down, which can affect the accuracy of test results. Therefore, specimens for bilirubin testing must be protected from light during handling and transportation to ensure valid results.
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