When a phlebotomist's hands are visibly soiled with blood or body fluids, which of the following decontamination agents should the phlebotomist use to clean them?

Choice A Reason:
Covering the spill until maintenance arrives is not an appropriate response to a blood spill. This action does not neutralize any potential pathogens present in the blood, which could pose a risk of infection to others. Immediate cleanup is necessary to prevent the spread of infectious diseases, and simply covering the spill does not meet the Occupational Safety and Health Administration (OSHA) guidelines for bloodborne pathogens, which require the spill to be cleaned with an appropriate disinfectant.

Choice B Reason:
Pouring bleach on the spill and allowing it to soak for 60 seconds is the recommended action because bleach is a powerful disinfectant that can kill a wide range of pathogens, including those that might be present in venous blood. The Centers for Disease Control and Prevention (CDC) recommends a 1:10 dilution of household bleach for effectively disinfecting blood spills. After pouring the bleach, it is important to let it soak for an adequate amount of time, usually around 10 minutes, to ensure that all pathogens are killed.

Choice C Reason:
Evacuating the laboratory is not a necessary action for a blood spill unless the spill is extensive and poses additional risks that cannot be mitigated by standard cleanup procedures. In most cases, following the proper spill cleanup protocol, which includes wearing personal protective equipment (PPE) and using an EPA-registered disinfectant, is sufficient to handle the situation without needing to evacuate the area.

Choice D Reason:
Applying a liquid thickening agent on top of the spill is not a standard practice for blood spill cleanup. While a thickening agent might contain the spill, it does not disinfect the area. The priority in such situations is to disinfect and remove any potential infectious agents. Therefore, the use of a thickening agent would not be in compliance with the recommended procedures for blood spill cleanup by OSHA and the CDC.

Choice A reason:
A sodium level test is important for managing and monitoring a patient's electrolyte balance, particularly in critical care settings. However, a DNR order indicates that the patient has chosen not to undergo CPR, not necessarily that their condition is the most critical at the moment. Therefore, while important, it may not be the most urgent sample to process.

Choice B reason:
Postoperative monitoring of hemoglobin and hematocrit levels is crucial for detecting possible hemorrhage and ensuring proper recovery. However, unless there is an immediate concern for acute blood loss or other complications, these tests may not be as urgent as a stat test from the emergency room.

Choice C reason:
A stat potassium level is typically ordered when there is an urgent need to assess a patient's potassium due to conditions that can rapidly affect heart rhythm and muscle function. In the emergency room setting, where patients often present with acute and life-threatening conditions, stat tests are prioritized to provide rapid results that can influence immediate clinical decisions.

Choice D reason:
Peak antibiotic levels are measured to ensure therapeutic efficacy and to avoid toxicity. While important for managing a patient's treatment, especially for those who are NPO (nothing by mouth), it may not be as time-sensitive as a stat test required for an acute emergency.