Blood Test

Blood Test

Collecting Blood for Routine Examination

Purposes

• To determine variations if any in blood composition.
• To determine any abnormality in order to aid in diagnosis.

Articles

• Tourniquet,
• Small makintosh,
• Syringes 5ml, 10 ml,
• Alcohol swabs,
• Disposable gloves,
• Specimen container,
• Laboratory requisition form,
• Sterile gauze pads,
•  Adhesive tapes.

Procedure

• Verify the doctor's prescription. Assure the patient that only a small amount of blood will be drawn. Put on gloves and wash your hands.
• Choose a vein to focus on and picture it, paying particular attention to the antecubital region, wrist, palm, and top of the foot. Touch the vein.
• The patient should be told to raise his arm. Clenched hand while holding the arm straight at the elbow.
• Apply the tourniquet with just enough pressure to stop venous flow, 5 to 15 cm above the chosen spot.
• Using an alcohol swab, gently cleanse the skin from the center outward. Permit to dry.
• Before placing the needle to stabilize the vein, tighten the skin directly below the location and fix the vein with your thumb.
• Hold the syringe with the bevel up and parallel to the vein's path between the thumb and final three fingers. Quickly and easily insert the needle into the vein and under the skin.
• By gently drawing back on the plunger, you can collect a blood sample.
• Once the specimen has been collected, remove the tourniquet and instruct the patient to open their fist.
• Cover the needle's buried portion with a cotton swab. With one swift motion, remove the needle from the swab.
• Ask the patient to press firmly but gently over the swab for two to four minutes.
• As soon as blood has been drawn, remove the needle from the syringe; carefully inject the blood sample into the proper container without causing bobbles in the test tube or bottle. Some tests need an anticoagulant container.
• If necessary, gently invert the tube several times to stir the blood and anticoagulant together.
• Blood is permitted to clot in the test tube for various procedures.
• Send the specimen to the lab right away with the completed requisition forms after properly labeling it.
• Include the procedure's date and time of collection in the patient's medical record.

Collecting Blood for Culture

• Evaluate the doctor's instruction.
• To the patient: Describe the procedure.
• Don gloves and wash your hands.
• Place a tourniquet over the venipuncture site and feel the area for pain.
• Allow the area to dry after wiping it with 70% alcohol in a circular motion that spans about a 5 cm circle. Povidone-iodine should be used once again to clean the area, beginning in the center and working outward. Iodine should be left on the skin for at least one minute.
• Take blood out of the vein with the needle.
• Once the blood has been collected, remove the tourniquet.
• Remove the needle while simultaneously applying pressure to the wound with dry cotton.
• Use 70% alcohol to clean the area.
• Push blood into each culture bottle after removing the metal top from the bottles.
• Be mindful not to touch the bottle's sides when you inject the blood into the bottles.
• By giving the bottle a little shake, combine the blood and culture medium.
• Throw away the infected items. Don't wear gloves.
• Hand washing.
• Label the culture bottles, then send them right away to the labs.
• Items should be replaced after cleaning.
• Include the date and time of collection along with the procedure in the nurse's note and patient chart.

General Instructions (Blood Culture)

• Blood for culture should be taken before antibiotics are administered.
• Blood should never be taken from an I.V line or from above an existing I.V line.
• Special types of culture bottles are used for blood culture sample collection.
• Only disposable syringes and needles should be used for collection of blood.

Measuring Blood Glucose Level Using Glucometer

Articles

• Blood glucose meter,
• Testing strip/reagent strips,
• Sterile lancet,
• Cotton balls,
• Alcohol swab,
•  Disposable gloves.

Procedure

• Check the physician's order.
• Gather articles at the bed side.
• Explain the procedure to the patient.
• Have the patient wash hands with soap and water.
• Position the patient comfortably in a semi-flowers position or upright position.
• Wash hands. Don disposable gloves.
• Remove test strip from the container and recap container immediately.
• Turn monitor on and check whether the code number on strip matches with the code number on the monitor screen.
• Take the lancet without contaminating it. Select appropriate puncture site.
• Massage side of finger for adults toward puncture site and wipe with alcohol swab.
• Hold lancet perpendicular to skin and prick site with lancet.
• Wipe away the 1st drop of blood from the site.
• Lightly squeeze or milk the puncture site until a hanging drop of blood has formed.
• Gently touch the drop of blood to pad on the test strip without smearing it.
• Insert strip into glucometer according to directions for that specific device.
• Apply pressure to the puncture site using a dry cotton ball.
• Read blood glucose results displayed on the monitor and inform the patient about results.
• Turn off the glucometer.
• Dispose supplies appropriately and discard lancet in a sharp's container.
• Remove gloves; wash hands.
• Record blood glucose level in the chart.

X-Rays

X-rays are electromagnetic waves that can penetrate through the body. X-rays are used to assess the shape, structure and function of certain body organs or parts.

Purposes

• To diagnose certain illness.
• To rule out the size, shape and position of body organs or part.

Preparation of Patient for X-Ray Examination

• The goal of the x-ray exams should be explained to the patient.
• Assure the patient that this examination won't hurt unless a particular technique is needed to introduce contrast media.
• Tell the patient that they cannot bring a visitor into the x-ray room.
• Let the patient know they must adhere to the technician's instructions. oitenpe pripsin sanoes
• Prepare the patient appropriately if more preparation for the exam is required.

Method of x-rays: 

Fluoroscopy: Fluoroscopy is a method of x-ray in which the image is not recorded in the film but the shadow can be studied directly on a radio sensitive plate. In this method a continuous flow of x-rays is possible. This method is usually used to study the structure as well as the function of different parts of the body like the heart, lungs, gastrointestinal tract, etc.

Plain x-ray: A plain x-ray is a film taken directly without introducing contrast media into the body. This method is used to study chest bones and sometimes the abdomen.

Soft tissue x-ray: Soft tissue x-ray is a method of taking x-ray of soft tissue after introducing contrast media or radio-opaque dye. The choice of radio-opaque dye and route of its administration vary with the organ to be studied. For example, to study the stomach and duodenum radio opaque substance i.e. barium sulphate is given orally immediately prior to x-ray examination.

Similarly barium enema is used to visualize the large intestine in x-ray. Oral cholecystograpy is the x-ray visualization of gall bladder following oral administration of radio-opaque iodine containing substances. Intravenous pylography is the x-ray visualization of kidney after introducing, the radio-opaque substance e.g. urograffin, intravenously.

Ultrasonography

Ultrasound waves are high frequency sound waves which are inaudible to the human ear. It is the procedure of visualizing body organs by using ultrasound waves. Ultrasonography can be used to examine the position, form and function of different organs. It is useful in diagnosing soft tissue disorders such as masses, fluid accumulation, etc.

The principle on which ultrasonography operates ultrasound waves that can pass through the skin and penetrate the soft tissue and then reflect back in various ways depending upon the density of the tissue.

While doing the procedure; a jelly like lubricant is applied over the skin to be examined. The transducer is applied over it and moved over. The lubricant serves as a conductor of sound waves and prevents air in coming in between the skin and transducer.

The ultrasound waves produced by transducer are transmitted through the skin to deeper tissues from where the beam is reflected back in various ways depending upon the density of the tissue. The reflected sound waves are converted into electrical waves by the transducer, and produce image of the body organs on the viewing screen which can be recorded.

Computerized Axial Tomography Scans (CT scan)

It is obtaining a computerized image that reproduces the desired section of brain or spinal cord. The CAT scan becomes an invasive procedure when radiopaque dye is injected into peripheral vein to give a contrast scan.

Computed trans-axial tomography is useful in the diagnosis of neurological disorders like neoplasm, hematoma, edema, infection, etc.

Purpose

To locate and diagnose various cranial lesions like: Abscess, Cyst, Tumor, Infarction, Hematoma, Aneurysms, Contusion and Hydrocephalus

Magnetic Resonance Imaging Scans (MRI)

Magnetic resonance imaging is a non-invasive scanning technique that provides visualization of internal organs and structures by means of magnetic forces rather than by ionizing radiation.

Purposes

• To diagnose pathologic lesions in organs or tissues.
• To provide contrast between normal and pathologic tissues.
• To distinguish white from gray matter and to identify conditions such as
  • Necrotic tissue.
  • Oxygen deprived tissue.
  • Small malignancies.
  • Degenerative disease of central nervous system.
  • Cerebral and spinal cord edema.
  • Hemorrhage.
  • Congenital anomalies.

Endoscopy

Endoscopy is the direct visualization of internal body organs by means of hollow tubular instrument with a light system.

Purposes

• to examine the inside organ for any abnormal abnormalities, such as a tumor, ulcer, or ulceration.
• to remove a tissue sample or biopsy.
• to remove an abscess from an organ.

Types of Endoscope

• Endoscopes come in many different varieties, including the laryngoscope, which is used to see the larynx.
• Using a bronchoscope to see the bronchi.
• To see the esophagus, use an oesophagoscope.
• Using a gastroscope to see the stomach
• Using a protoscope to see the rectus.

Preparation of the Patient

• Under local anesthetic, endoscopy is performed, and the majority of endoscopic exams are uncomfortable for the patient. As a result, it's important to describe the operation to the patient.
• To reduce the risk of aspiration, food and liquid intake should be restricted 4 to 6 hours before the endoscopy.
• The patient is often administered an analgesic or sleepy medicine around 30 minutes before to the examination to lessen pain.
• Tell the patient to take a few deep breaths when the endoscope is inserted.
• Keep an eye on the patient's condition, particularly any changes in color and pulse.