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 C
Explanation
Choice A reason:
The laboratory accession number is a unique identifier assigned to a patient's specimen once it is received by the laboratory. While it is an important piece of information, it is not provided by the physician's office to the phlebotomist for specimen collection. Instead, it is generated by the laboratory after the specimen is collected and submitted for analysis.
Choice B reason:
The Physician's NPI (National Provider Identifier) number is a unique identification number for covered health care providers in the United States. While it is used for billing and identification purposes, it is not the information that the physician's office needs to provide to a phlebotomist for the purpose of specimen collection.
Choice C reason:
The laboratory requisition form is the correct document that should be provided by the physician's office. This form contains the patient's demographic information, the tests ordered by the physician, special instructions for specimen collection, and any other pertinent information required for proper specimen handling and testing.
Choice D reason:
The physician's encounter form typically contains details of the patient's visit, including services provided, diagnoses, and billing information. It is not specifically used for laboratory specimen collection and therefore is not the information that should be provided to a phlebotomist for this purpose.
Correct Answer is D
Explanation
Choice A Reason:
Anchoring the vein does not eliminate the need for a tourniquet. The tourniquet is applied to engorge the veins, making them more prominent and easier to puncture. Anchoring is a technique used after the tourniquet has already accomplished this task.
Choice B Reason:
While anchoring the vein can provide a more stable area for needle insertion, which might indirectly reduce pain, its primary purpose is not pain reduction. Pain during needle insertion is more directly influenced by the needle gauge, angle of insertion, and the phlebotomist's technique.
Choice C Reason:
Improving vein identification is not the direct purpose of anchoring. Vein identification is typically done visually and by palpation before the application of the tourniquet and before anchoring the vein. Anchoring is performed to stabilize the vein once it has been identified.
Choice D Reason:
The primary purpose of anchoring the vein is to minimize its movement during venipuncture. This is important because it helps prevent the needle from slipping out of or through the vein, which can cause discomfort and bruising, and may require another puncture attempt.
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