Question

Description:

Sylvia Gonzales, a 51-year-old female, is at the office for a 3-month return check for her newly diagnosed Type 2 diabetes. She states that she has taken the medication she received for her “sugar” and she knows the doctor wants to a do a special “sugar test” this time. Her medication list includes Januvia®100 mg daily. The physician has ordered a fasting blood sugar (FBS), electrolytes, and a CBC. You will need to collect a venipuncture blood specimen to send the lab. During the examination Sylvia states, she is feeling lightheaded, so the licensed practitioner asks you to perform a waived blood sugar and hemoglobin A1C immediately.

Discussion Questions:

1. What blood tube(s) would you fill to collect a specimen for the CBC and lytes?

2. Compare a fasting blood sugar test to a hemoglobin A1C test.

3. What steps will you take to perform a dermal puncture?

4. If Sylvia tells you that she ate breakfast before coming in for the test, what should you do?

Note: Please answer all 4 questions separately. Very important.Thanks

Answer 1

1) For testing CBC, blood is collected in EDTA ( anticoagulant) tube. It has lavender coloured top tube

For testing electrolyte panel, plain red top tube is used to collect blood.

2) FBS refers to as fasting blood sugar which is the blood test done by a patient after he fast for at least 8 hours. It is more accurate than HbA1c. Normal range of FBS is less than 100 mg/dl

Whereas HbA1c is the average blood glucose level for last 2-3 months ( 12 weeks minimum). It can be done at any time and no need to of fasting.

3) steps taken for a dermal puncture

• Article preparation
  • A sterile tray containing
  • Syringe
  • Cottondry swab
  • Spirit swab
  • Tourniquet
  • Blood collection tubes
  • Adhesive tape
• Perform hand hygiene
• Position patient
• Apply tourniquet before the area of puncture
• Palpate vein and Clean the area of puncture with spirit swab
• Insert bevel of syringe at an angle of 35-45 degree
• Loosen the tourniquet
• Withdraw blood
• If the syringe is proper to attach the blood collection tubes.
• Collect blood via tubes
• Withdraw syringe
• Press the area of puncture with cotton swab and apply adhesive tape
• Send sample to lab for testing
• After care of articles
• Hand hygiene
• Documentation

4) for testing fasting blood sugar, the patient need to take blood after fast for at least 8 hours. If the patient take breakfast before doing FBS it will affect the test result, because the patient show a higher blood sugar level than if the patient hadn't had anything.

So if the patient take breakfast already, the nurse can do a post prandal blood sugar ( ppbs) which is done 2 hours after food.