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PATIENT PREPARATIONS & INTERFERING FACTORS IN ENDOCRINE & METABOLISM SYSTEM. DEPARTMENT OF CLINICAL PATHOLOGY MEDICAL SCHOOL-UNIVERSITAS PADJADJARAN/ RUMAH SAKIT DR.HASAN SADIKIN BANDUNG. PATIENTS. NURSES. REPORTING/ RECORDING SYSTEM. GOOD LAB.RESULTS. DOCTORS. LAB.METHODS, QC.
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PATIENT PREPARATIONS & INTERFERING FACTORS IN ENDOCRINE & METABOLISM SYSTEM DEPARTMENT OF CLINICAL PATHOLOGY MEDICAL SCHOOL-UNIVERSITAS PADJADJARAN/ RUMAH SAKIT DR.HASAN SADIKIN BANDUNG
PATIENTS NURSES REPORTING/ RECORDING SYSTEM GOOD LAB.RESULTS DOCTORS LAB.METHODS, QC LAB.TECHNICIANS
PATIENT PREPARATIONS: • Ambulatory patients : done by themselves • Hospitalized patients : done by themselves, or nurses • Food: • Fasting; non-fasting; food & fluids restriction; ad-random
PATIENT PREPARATIONS (cont.): • Drugs: • Continue; withholding (if must be continued, record it in the lab. requisition sheet) • Activity/ emotion: • Resting, relax, enough sleep duration, seated, recumbent
SAMPLES/ SAMPLE COLLECTION: • Kind of samples: arterial; venous; capillary blood; urine • Time: 12-hour urine; 24-hour urine; pooled serum samples; morning & afternoon samples; midnight.
POTENTIAL INTERFERING FACTORS: • Foods: carbohydrate, protein, lipid; coffee, tea, radish, vitamin C, vitamin E, minerals • Drugs: varied : hormones, steroids, antihyper-tension; oral anti-diabetic, etc. • Sites of sampling: avoid to collect the samples from the same site with the IV-line vessels
POTENTIAL INTERFERING FACTORS (cont.): • Devices/container: plastic-tubes, glass-tubes; rubber stopper; clot-separator containing tubes, etc. • Anticoagulants : Heparin; oxalate; citrate; Na3- EDTA; K2- EDTA; K3- EDTA • Hemolysis; also: icteric samples; coloration from any sources.
LAB.EXAMINATIONS IN EMS: • Hormones or hormone metabolites • Antibody against hormones or its binding proteins • Glucose and its related metabolites • Electrolytes : Ca, Phosphates • Others (parameters which detect complica-tions, i.e. ketone bodies, lipid; uric acid, micro albumin urine, etc.)
Bibliography: • St.John,A; Critical care testing. A quick reference guide. 2001, Roche Diagnostic, Mannheim Germany • Henry JB; Clinical Diagnosis and Management by Laboratory Method; 19th ed 1996; W.B. Saunders Co • Wallach J; Interpretation of Diagnostic Tests; 7th ed. 2000, Lippincott Williams & Wilkins, Wolters Kluwer Co. • Breuninger CM, Wittig P; Diagnostics - An A to Z Guide to Laboratory Tests and Diagnostic Procedures; 2001, Springhouse Corp, Pennsylvania • Gaedeke MK, Laboratory and Diagnostic Tests Handbook, 1996, Addison-Wesley, The Benjamin/Cummings Publishing Co