NHA Phlebotomy Certification Practice Exam

What should a phlebotomist do if a Tobramycin level is ordered to be drawn one hour after a dose?

1. Draw the sample immediately

2. Wait two hours before drawing

3. Check with the nurse about medication administration

4. Contact the physician for clarification

The correct answer is: Check with the nurse about medication administration

In the context of obtaining a Tobramycin level, it is essential to draw the sample at the appropriate time to ensure accurate results for therapeutic drug monitoring. Tobramycin is an aminoglycoside antibiotic, and its levels need to be precisely timed in relation to the last dose to assess whether the drug concentration is within the therapeutic range. Checking with the nurse about medication administration is vital because it confirms the timing of the last dose. The phlebotomist needs to ensure that they wait the correct duration after the last dose to avoid either a peak level (which should be measured shortly after drug administration) or a trough level (which is typically measured just before the next dose). This confirmation helps in obtaining the right level at the right time, making it crucial for optimizing patient care and ensuring sufficient therapeutic monitoring. The other choices do not fully address the need for precise timing concerning medication administration. Drawing immediately, waiting two hours, or contacting a physician for clarification without first verifying the medication administration schedule wouldn’t ensure that the blood draw aligns with the necessary pharmacokinetic principles required for accurate testing of drug levels.