Which of the following specimens has a phlebotomist appropriately prepared for transport?

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.

Choice A Reason:
A quiet and professional tone of voice is essential for a phlebotomy technician when introducing themselves to a patient. This tone conveys respect and maintains a calm environment, which is particularly important in healthcare settings where patients may be anxious or fearful about medical procedures. A professional demeanor helps to establish trust and reassures the patient that they are in capable hands.

Choice B Reason:
A loud and authoritative tone is not appropriate when introducing oneself to a patient. It can be intimidating and may increase the patient's anxiety. The goal is to make the patient feel comfortable and safe, not overpowered or coerced.

Choice C Reason:
Being assertive and humorous can sometimes help to lighten the mood and make the patient feel more at ease. However, humor must be used judiciously as it may not be well-received by all patients, especially in a medical setting where they might be experiencing stress or discomfort.

Choice D Reason:
A commanding and confident tone may convey confidence, but it can also come across as overbearing. While confidence is important, it should not overshadow the need for empathy and understanding of the patient's feelings and comfort.