A sample arrives with GLU 24.8 mmol/L, TP 33 g/L, Na 128 mmol/L, K 2.1 mmol/L. What is this indicative of?

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Multiple Choice

A sample arrives with GLU 24.8 mmol/L, TP 33 g/L, Na 128 mmol/L, K 2.1 mmol/L. What is this indicative of?

When a blood sample is drawn from or near an IV fluid line, the result can be a mix of the patient’s blood with the IV solution. If the IV contains dextrose, glucose in the sample can be falsely very high; the same fluid dilutes plasma components, so total protein drops and electrolytes like sodium and potassium can appear low. Here, glucose is markedly elevated while total protein, sodium, and potassium are all decreased, which fits the picture of dilution from IV fluids plus glucose infusate rather than a true patient profile. The correct action is to reject the sample and recollect from a venipuncture away from any IV line, after flushing or stopping the IV as appropriate. (Hemolysis would usually alter potassium and other values in a different pattern and wouldn’t explain such a massive spike in glucose with concurrent dilution across other analytes.)

When a blood sample is drawn from or near an IV fluid line, the result can be a mix of the patient’s blood with the IV solution. If the IV contains dextrose, glucose in the sample can be falsely very high; the same fluid dilutes plasma components, so total protein drops and electrolytes like sodium and potassium can appear low. Here, glucose is markedly elevated while total protein, sodium, and potassium are all decreased, which fits the picture of dilution from IV fluids plus glucose infusate rather than a true patient profile. The correct action is to reject the sample and recollect from a venipuncture away from any IV line, after flushing or stopping the IV as appropriate.

(Hemolysis would usually alter potassium and other values in a different pattern and wouldn’t explain such a massive spike in glucose with concurrent dilution across other analytes.)

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