I have a patient that had a  dual lumen power PICC inserted on 8-3-06.  TPN was initiated through one lumen and the other lumen utilized for maintaince fluids (D51/2 NS) and lab draws.  The last 3-4 days (not consecutive) the patient's glucose has been elevated on the lab results, but a finger stick has had much lower results.  The patient's WBC's are elevated, but not a new finding.  The physician is concerned with infection.  My first thought was that the nurses are pulling the TPN with their lab draw.--It is common practice on this floor to draw the lab work while the TPN is infusing, so I suggested to stop it briefly before the next lab draw to see if there is a difference in the results. 
With the background given, what are your thoughts on possible infection vs. the nurses "technique" on obtaining the sample?
Thanks, G.G.
 
G.G. Northington,RN,BSN
PICC Nurse
Jackson Hospital & Clinic,Inc. 
Montgomery,AL  36016
334-293-6858
[EMAIL PROTECTED]
 

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