HEMATOLOGY REPORT

PRETEST:
1. Positively identify the patient using at least two unique identifiers before providing
care, treatment, or services.
2. Inform the patient that the test is used to evaluate numerous conditions involving
red blood cells, white blood cells, and platelets. The test is also used to indicate
inflammation, infection, and response to chemotherapy.
3. Obtain a history of the patients complaints, including a list of known allergens,
especially allergies or sensitivities to latex.
4. Obtain a history of the patients gastrointestinal, hematopoietic, immune, and
respiratory systems, as well as results of previously performed laboratory tests
and diagnostic and surgical procedures.
5. Obtain a list of the patients current medications, including herbs, nutritional
supplements, and nutraceuticals.
6. Review the procedure with the patient. Inform the patient that specimen
collection takes approximately 5 to 10 min. Address concerns about pain and
explain that there may be some discomfort during the venipuncture.
7. Sensitivity to social and cultural issues, as well as concern for modesty, is
important in providing psychological support before, during, and after the
procedure.
8. There are no food, fluid, or medication restrictions unless by medical direction.
INTRATEST:
1. If the patient has a history of allergic reaction to latex, avoid the use of equipment
containing latex.
2. Instruct the patient to cooperate fully and to follow directions. Direct the patient to
breathe normally and to avoid unnecessary movement.
3. Observe standard precaution. Positively identify the patient, and label the
appropriate tubes with the corresponding patient demographics, date, and time of
collection. Perform a venipuncture. An EDTA Microtainer sample may be
obtained from infants, children, and adults for whom venipuncture may not be
feasible. The specimen should be analyzed within 6 hr when stored at room
temperature or within 24 hr if stored at refrigerated temperature. If it is anticipated
that the specimen will not be analyzed within 4 to 6 hr, two blood smears should
be made immediately after the venipuncture and submitted with the blood
sample. Smears made from specimens older than 6 hr will contain an
unacceptable number of misleading artifactual a bnormalities of the RBCs, such
as echinocytes and spherocytes, as well as necrobiotic WBCs.
4. Remove the needle and apply direct pressure with dry gauze to stop bleeding.
Observe venipuncture site for bleeding or hematoma formation and secure gauze
with adhesive bandage.
5. Promptly transport the specimen to the laboratory for processing and analysis.

POST-TEST:
1. A report of the results will be sent to the requesting HCP, who will discuss the
results with the patient.
2. Nutritional considerations: Instruct patients to consume a variety of foods within
the basic food groups, maintain a healthy weight, be physically active, limit salt
intake, limit alcohol intake, and avoid use of tobacco.
3. Reinforce information given by the patients HCP regarding further testing,
treatment, or referral to another HCP. Answer any questions or address any
concerns voiced by the patient or family.
4. Depending on the results of this procedure, additional testing may be performed
to evaluate or monitor progression of the disease process and determine the
need for a change in therapy. Evaluate relation to the patients symptoms and
other tests performed. Test results in relation to the patients symptoms and other
tests performed.
CLINICAL CHEMISTRY
PRETEST:
1. Positively identify the patient using at least two unique identifiers before providing
care, treatment, or services.
2. Inform the patient that the test is used to assess kidney function.
3. Obtain a history of the patients complaints, including a list of known allergens,
especially allergies or sensitivities to latex.
4. Obtain a history of the patients genitourinary and musculoskeletal systems,
symptoms, and results of previously performed laboratory tests and diagnostic
and surgical procedures.
5. Obtain a list of the patients current medications, including herbs, nutritional
supplements, and nutraceuticals.
6. Review the procedure with the patient. Inform the patient that specimen
collection takes approximately 5 to 10 min. Address concerns about pain and
explain that there may be some discomfort during the venipuncture.
7. Sensitivity to social and cultural issues, as well as concern for modesty, is
important in providing psychological support before, during, and after the
procedure.
8. There are no food, fluid, or medication restrictions unless by medical direction.
9. Instruct the patient to refrain from excessive exercise for 8 hr before the test.
INTRATEST:
1. Ensure that the patient has complied with activity restrictions; assure that activity
has been restricted for at least 8 hr prior to the procedure.
2. If the patient has a history of allergic reaction to latex, avoid the use of equipment
containing latex.

3. Instruct the patient to cooperate fully and to follow directions. Direct the patient to
breathe normally and to avoid unnecessary movement.
4. Observe standard precautions, and follow the general guidelines. Positively
identify the patient, and label the appropriate tubes with the corresponding
patient demographics, date, and time of collection. Perform a venipuncture.
5. Remove the needle, and apply a pressure dressing over the puncture site.
6. Promptly transport the specimen to the laboratory for processing and analysis.
POST-TEST:
1. A report of the results will be sent to the requesting HCP, who will discuss the
results with the patient.
2. Instruct the patient to resume usual activity as directed by the HCP.
3. Nutritional considerations: Increased creatinine levels may be associated with
kidney disease. The nutritional needs of patients with kidney disease vary widely
and are in constant flux. Anorexia, nausea, and vomiting commonly occur,
prompting the need for continuous nutritional monitoring for malnutrition,
especially among patients receiving long-term hemodialysis therapy.
4. Recognize anxiety related to test results. Discuss the implications of abnormal
test results on the patients lifestyle. Provide teaching and information regarding
the clinical implications of the test results, as appropriate. Educate the patient
regarding access to counseling services.
5. Reinforce information given by the patients HCP regarding further testing,
treatment, or referral to another HCP. Answer any questions or address any
concerns voiced by the patient or family.
6. Depending on the results of this procedure, additional testing may be performed
to evaluate or monitor progression of the disease process and determine the
need for a change in therapy. Evaluate test results in relation to the patients
symptoms and other tests performed.
ELECTROLYTES
PRETEST:
1. Positively identify the patient using at least two unique identifiers before providing
care, treatment, or services.
2. Inform the patient that the test is used to evaluate electrolytes, acid-base
balance, and hydration level.
3. Obtain a history of the patients complaints, including a list of known allergens,
especially allergies or sensitivities to latex.
4. Obtain a history of the patients cardiovascular, endocrine, gastrointestinal,
genitourinary, and respiratory systems, as well as results of previously performed
laboratory tests and diagnostic and surgical procedures.
5. Specimens should not be collected during hemodialysis.

6. Obtain a list of the patients current medications, including herbs, nutritional

supplements, and nutraceuticals.
7. Review the procedure with the patient. Inform the patient that specimen
collection takes approximately 5 to 10 min. Address concerns about pain and
explain that there may be some discomfort during the venipuncture.
8. Sensitivity to social and cultural issues, as well as concern for modesty, is
important in providing psychological support before, during, and after the
procedure.
9. There are no food, fluid, or medication restrictions unless by medical direction.
INTRATEST:
1. If the patient has a history of allergic reaction to latex, avoid the use of equipment
containing latex.
2. Instruct the patient to cooperate fully and to follow directions. Direct the patient to
breathe normally and to avoid unnecessary movement. Instruct the patient not to
clench and unclench fist immediately before or during specimen collection.
3. Observe standard precautions. Positively identify the patient, and label the
appropriate tubes with the corresponding patient demographics, date, and time of
collection. Perform a venipuncture.
4. Remove the needle and apply direct pressure with dry gauze to stop bleeding.
Observe venipuncture site for bleeding or hematoma formation and secure gauze
with adhesive bandage.
5. Promptly transport the specimen to the laboratory for processing and analysis.
POST-TEST:
1. A report of the results will be sent to the requesting HCP, who will discuss the
results with the patient.
2. Observe the patient on saline IV fluid replacement therapy for signs of over
hydration, especially in cases in which there is a history of cardiac or renal
disease. Signs of over hydration include constant, irritable cough; chest rales;
dyspnea; or engorgement of neck and hand veins.
3. Evaluate the patient for signs and symptoms of dehydration. Check the patients
skin turgor, mucous membrane moisture, and ability to produce tears.
Dehydration is a significant and common finding in geriatric and other patients in
whom renal function has deteriorated.
4. Monitor daily weights as well as intake and output to determine whether fluid
retention is occurring because of sodium and chloride excess. Patients at risk for
or with a history of fluid imbalance are also at risk for electrolyte imbalance.
5. Nutritional considerations: Careful observation of the patient on IV fluid
replacement therapy is important. A patient receiving a continuous 5% dextrose
solution (D5W) may not be taking in an adequate amount of chloride to meet the
bodys needs. The patient, if allowed, should be encouraged to drink fluids such
as broths, tomato juice, or colas and to eat foods such as meats, seafood, or

6.

7.

8.
9.

eggs, which contain sodium and chloride. The use of table salt may also be
appropriate.
Nutritional considerations: Instruct patients with elevated chloride levels to avoid
eating or drinking anything containing sodium chloride salt. The patient or
caregiver should also be encouraged to read food labels to determine which
products are suitable for a low-sodium diet.
Nutritional considerations: Instruct patients with low chloride levels that a
decrease in iron absorption may occur as a result of less chloride available to
form gastric acid, which is essential for iron absorption. In prolonged periods of
chloride deficit, iron-deficiency anemia could develop.
Reinforce information given by the patients HCP regarding further testing,
treatment, or referral to another HCP. Answer any questions or address any
concerns voiced by the patient or family.
Depending on the results of this procedure, additional testing may be performed
to evaluate or monitor progression of the disease process and determine the
need for a change in therapy. Evaluate test results in relation to the patients
symptoms and other tests performed.

URINALYSIS
PRETEST:
1. Positively identify the patient using at least two unique identifiers before providing
care, treatment, or services.
2. Inform the patient that the test is used to assist in the diagnosis of renal disease,
urinary tract infections, and neoplasms of the urinary tract, and as an indication
of systemic or inflammatory diseases.
3. Obtain a history of the patients complaints, including a list of known allergens,
especially allergies or sensitivities to latex.
4. Obtain a history of the patients endocrine, genitourinary, immune, hematopoietic,
hepatobiliary, and reproductive systems, symptoms, and results of previously
performed laboratory tests and diagnostic and surgical procedures.
5. Obtain a list of the patients current medications, including herbs, nutritional
supplements, and nutraceuticals.
6. Review the procedure with the patient. If a catheterized specimen is to be
collected, explain this procedure to the patient, and obtain a catheterization tray.
Address concerns about pain and explain that there should be no discomfort
during the procedure. Inform the patient that specimen collection takes
approximately 5 to 10 min.
7. Sensitivity to social and cultural issues, as well as concern for modesty, is
important in providing psychological support before, during, and after the
procedure.
8. There are no food, fluid, or medication restrictions, unless by medical direction.

INTRATEST:
1. If the patient has a history of allergic reaction to latex, avoid the use of equipment
containing latex.
2. Instruct the patient to cooperate fully and to follow directions. Direct the patient to
breathe normally and to avoid unnecessary movement.
3. Observe standard precautions, and follow the general guidelines. Positively
identify the patient, and label the appropriate collection container with the
corresponding patient demographics, date, and time of collection.
4. Random Specimen (collect in early morning):
Clean-catch specimen:
5. Instruct the male patient to (1) Thoroughly wash his hands, (2) cleanse the
meatus, (3) void a small amount into the toilet, and (4) void directly into the
specimen container.
6. Instruct the female patient to (1) Thoroughly wash her hands; (2) cleanse the
labia from front to back; (3) while keeping the labia separated, void a small
amount into the toilet; and (4) without interrupting the urine stream, void directly
into the specimen container.
Pediatric Urine Collector:
1. Put on gloves. Appropriately cleanse the genital area, and allow the area to dry.
Remove the covering over the adhesive strips on the collector bag, and apply the
bag over the genital area. Diaper the child. When specimen is obtained, place
the entire collection bag in a sterile urine container.
Indwelling Catheter:
1. Put on gloves. Empty drainage tube of urine. It may be necessary to clamp off
the catheter for 15 to 30 min before specimen collection. Cleanse specimen port
with antiseptic swab, and then aspirate 5 mL of urine with a 21- to 25-gauge
needle and syringe. Transfer urine to a sterile container.
Urinary Catheterization:
1. Place female patient in lithotomy position or male patient in supine position.
Using sterile technique, open the straight urinary catheterization kit and perform
urinary catheterization. Place the retained urine in a sterile
Suprapubic Aspiration:
1. Place the patient in a supine position. Cleanse the area with antiseptic and drape
with sterile drapes. A needle is inserted through the skin into the bladder. A
syringe attached to the needle is used to aspirate the urine sample. The needle

is then removed and a sterile dressing is applied to the site. Place the sterile
sample in a sterile specimen container.
2. Do not collect urine from the pouch from the patient with a urinary diversion (e.g.,
ilieal conduit). Instead, perform catheterization through the stoma.
General:
1. Include on the collection containers label whether the specimen is clean catch or
catheter and any medications that may interfere with test results.
2. Promptly transport the specimen to the laboratory for processing and analysis.

POST-TEST:
1. A report of the results will be sent to the requesting HCP, who will discuss the
results with the patient.
2. Instruct the patient to report symptoms such as pain related to tissue
inflammation, pain or irritation during void, bladder spasms, or alterations in
urinary elimination.
3. Observe for signs of inflammation if the specimen is obtained by suprapubic
aspiration.
4. Recognize anxiety related to test results. Discuss the implications of abnormal
test results on the patients lifestyle. Provide teaching and information regarding
the clinical implications of the test results, as appropriate. Instruct the patient with
a UTI, as appropriate, on the proper technique for wiping the perineal area (front
to back) after a bowel movement. UTIs are more common in women who use
diaphragm/spermicide contraception. These patients can be educated, as
appropriate, in the proper insertion and removal of the contraceptive device to
avoid recurrent UTIs.
5. Reinforce information given by the patients HCP regarding further testing,
treatment, or referral to another HCP. Instruct the patient to begin antibiotic
therapy, as prescribed, and instruct the patient in the importance of completing
the entire course of antibiotic therapy even if symptoms are no longer present.
Answer any questions or address any concerns voiced by the patient or family.
6. Depending on the results of this procedure, additional testing may be performed
to evaluate or monitor progression of the disease process and determine the
need for a change in therapy. Evaluate test results in relation to the patients
symptoms and other tests performed.
CHEST X-RAY
PRETEST:

1. Positively identify the patient using at least two unique identifiers before providing
care, treatment, or services.
2. Inform the patient that the procedure assesses cardiopulmonary status.
3. Obtain a history of the patients symptoms and complaints, including a list of
known allergens.
4. Obtain a history of the patients cardiovascular and respiratory system,
symptoms, and results of previously performed laboratory tests and diagnostic
and surgical procedures.
5. Record the date of the last menstrual period and determine the possibility of
pregnancy in perimenopausal women.
6. Obtain a list of the patients current medications, including herbs, nutritional
supplements, and nutraceuticals.
7. Review the procedure with the patient. Address concerns about pain and explain
that no pain will be experienced during the test. Inform the patient that the
procedure is performed in the radiology department or at the bedside by a
registered radiological technologist, and takes approximately 5 to 15 min.
8. Sensitivity to social and cultural issues, as well as concern for modesty, is
important in providing psychological support before, during, and after the
procedure.
9. Instruct the patient to remove all metallic objects from the area to be examined.
10. There are no food, fluid, or medication restrictions unless by medical direction.

INTRATEST:
1. Ensure that the patient has removed all external metallic objects from the area to
be examined.
2. Patients are given a gown, robe, and foot coverings to wear.
3. Instruct the patient to cooperate fully and to follow directions. Instruct the patient
to remain still throughout the procedure because movement produces unreliable
results.
4. Place the patient in the standing position facing the cassette or image detector,
with hands on hips, neck extended, and shoulders rolled forward.
5. Position the chest with the left side against the image holder for a lateral view.
6. For portable examinations, elevate the head of the bed to the high Fowlers
position.
7. Ask the patient to inhale deeply and hold his or her breath while the x-ray
images are taken, and then to exhale after the images are taken.

POST-TEST:

1. The report will be sent to the requesting HCP, who will discuss the results with
the patient.
2. Recognize anxiety related to test results and be supportive of impaired activity
related to respiratory capacity and perceived loss of physical activity. Discuss the
implications of abnormal test results on the patients lifestyle. Provide teaching
and information regarding the clinical implications of the test results, as
appropriate.
3. Reinforce information given by the patients HCP regarding further testing,
treatment, or referral to another HCP. Answer any questions or address any
concerns voiced by the patient or family.
4. Depending on the results of this procedure, additional testing may be performed
to evaluate and determine the need for a change in therapy or progression of the
disease process. Evaluate test results in relation to the patients symptoms and
other tests performed.