PKU Testing: Do you do your own or does Lab do it? - page 2

One more question: Do you do your own PKU's or does lab do it? If you do your own, is it a chargeable item? Thanks for your input- much appreciated! Layna... Read More

  1. by   palesarah
    Originally posted by rn500
    The lab does it where I work now, everywhere else I've worked, the nurses did it. This sounds a little weird, but I actually LIKED doing them - it was a challenge and I had gotten really good at filling that WHOLE CIRCLE with ONE drop of blood, like you're supposed to :-)
    WOW, with one drop of blood? Impressive! I just started on an LDRP floor and we do our own PKUs (part of the OB rate, not a separate charge; I was told that little slip of paper costs us $18). Not very good at them yet. I hate doing heelsticks!
  2. by   SmilingBluEyes
    one BIG juicy drop of blood is PLENTY to fill a dot, done right. that is another advantage of IV route. (or a well warmed heel).
  3. by   judy ann
    Gosh, it takes me about an hour to do a PKU. Twenty minutes to explain the proceedure to the patient, just a second or so to do it and at least fourty minutes to appologize.
    Last edit by judy ann on Aug 11, '03
  4. by   Mira
    explaining the procedure emphasizing the word "important/essential to prevent long term damage...",a good massage on the heel with vaseline/paraffin before heel prick plus a nice hug to settle the baby after, shortens the procedure and prevents mother and child from getting so distressed.
  5. by   SmilingBluEyes
    Well for me, the explanation of the implications of the disorders we are trying to discover is USUALLY more than enough for the parents to understand and comply. If they refuse, they sign a statement indicating such after being counseled and are NOT pressured further by me.

    I also explain that it is NEVER easy to watch their baby get shots and be in pain, but it does occur and we have to deal with it and be strong. Our kids depend on it and look to our reactions as to how to deal with these things as they get older. I encourage them to be present when I draw the PKU (or do other procedures for their babies). They can see for them selves how quick and relatively little trauma can be involved, if done right. Good heel prep is essential. So is comforting the baby. I let the baby nurse, suck on mom's finger, or just be held as I do this. The foot hanging down from mom also helps me take advantage of gravity in making the draw more smooth. Most babies protest when you have to "milk" the heel for blood, not at the prick of the lancet itself. That is fleeting.

    Yes, having mom or dad present also increases the trust between us. Nothing is going on they are not participating in and can not see for themselves. I encourage their involvement for trustbuilding AND getting them used to being there for procedures and exams in their babies' futures. Most of the time, they are very understanding, reassured and trust me when I approach it this way. The State Health Dept has a GREAT website also which I can refer them to for further info on PKU/lab draws and the tests we do and what exactly they mean. Information is power and no parent should be without it.

    Each state has its own requirements and tests......ours only runs FOUR------there are so many more we could be doing. Oh well, that is another thread. One last point: I do not believe in apologizing when doing this procedure----- I just explain why this test is so critical, give them plenty of written information and referral to the state health dept web site and they will understand. Apologizing is as bad as saying you are wrong in doing this and does nothing much to foster trust. Not a pleasant procedure but necessary. Oh well, I spoke too much as usual...

  6. by   judy ann
    You will notice that I did not mention the parents. I only spoke of the patient. Of course, in this situation, it is important to inform the parents of the proceedure, etc, but I also feel obligated to inform the patient! He's the one getting stuck! (Besides I love to cuddle babies)
    Last edit by judy ann on Aug 14, '03
  7. by   SmilingBluEyes
    awww judy you are sweet. yes, the patient is number one!!!!