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Specimen collection
This document provides information and guidelines for nurses on collecting various specimen types including urine, stool, sputum, blood, and wound drainage. It describes the proper procedures for collecting midstream urine samples, stool samples, and sputum samples. It emphasizes the importance of using standard precautions, proper labeling of specimens, and timely delivery of specimens to the laboratory. It also provides information on testing of urine, stool, and sputum samples in the laboratory.
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Specimen collection
- 1. Role of theNurse MANJU MULAMOOTTIL
- 2. Specimens consist ◦Urine ◦ Stool ◦ Sputum ◦ Wound drainage ◦ Blood
- 3. Comfort Privacy Questions Clear, concise directions ◦ NPO
- 4. Check physicianorders Keep it Simple directions to client Standard precautions Label specimen Timely C&S to lab ASAP or refrigerated Documentation
- 5. Random Clean Female ? Menses (make note) Tested for: Specific gravity pH Albumin Glucose Microscopic exam
- 6. Culture =? Bacteria growing Sensitivity = which antibiotics are effective Readings after 24; 48; 72 hrs. Midstream Urine Sterile Catheter Specimen (never from bag)
- 7. ? UrinaryTract Infection (UTI) ◦ Frequency ◦ Urgency ◦ Dysuria ◦ Hematuria ◦ Flank pain ◦ Fever ◦ Cloudy, malodorous urine
- 8. Wash hands Clean meatus, female front to back Start stream, then stop, collect specimen Aseptic technique Bedpan/mexican hat To lab 15-20min post collection
- 9. Pediatric bags( u Bag) Never squeeze diaper
- 10.
- 11. 1. Random Specimens Clean-not sterile Ordered for Urinalysis testing Measurement of specific gravity pH Glucose levels
- 12. 2. Midstream Specimen Clean voided C&S 30-60 mls urine 3. Sterile Specimen Indwelling catheter Drainage bag
- 13. 4. Timed urinespecimens 2-72 hr intervals (24hr most common) Begin after urinating Note start time on container & requisition Collect all urine in timed period Post Reminder Signs
- 14. Strict aseptictechnique Only from Bag if Brand new Sampling Port? Clamp 30 min. prior Wash hands – Glove Cleanse port with alcohol swab Sterile needle To lab 30 min (may refridge 2hrs)
- 15. Routine Urinalysis ◦Examine within 2hrs ◦ 1st voided specimen in AM ◦ Reagent strip Specific Gravity ◦ Concentration ◦ 1.010-1.025 Urine glucose ◦ Diabetics ◦ Reagent strips ◦ Double void
- 16. Glucose Ketones Protein Blood- hematuria pH Specific gravity Microscopic examination
- 17. Analysis of fecalmaterial can detect pathological conditions ie: tumors, hemorrhage, infection Tests ◦ OB ◦ Pus ◦ Ova & Parasites
- 19. ? Chemicalpreservatives Medical aseptic technique To lab on time Labelling Documentation Guaiac Test Colorectal cancer screening test FOBT Hemoccult slide test
- 20. Color ◦ melena Odor Consistency Frequency Amount Shape Constituents
- 21. Single positivetest result does not confirm bleeding or colorectal cancer. Repeat test 3X Meat free, high residue diet
- 22. Normally thin,nonpurulent, whitish or clear, small in amount S&S STD’s, UTI Not Delegated Assess external genitalia If STD record sexual history Physician’s order- vaginal/urethral
- 23. Lab techs ABG’s Blood Glucose
- 25. Tests todetermine abnormal cells or infection ◦ Throat cultures ◦ Sputum specimens ◦ Skin testing ◦ Thoracentesis
- 26. Upper respiratory/throat infections Should Not be delegated Throat swabs ◦ ac meal or 1 hr pc meal ◦ Wash hands, glove ◦ Tilt head backward ◦ “ah” ( if pharynx not visualized, tongue depressor, anterior 1/3 of tongue) ◦ Don’t contaminate
- 27. Oropharynx &tonsillar Sterile swab Culture determines pathogenic microorganisms Sensitivity determines the antibiotics to which the microorganisms are sensitive or resistant
- 28. Insert swabinto pharyngeal region Reddened areas/ exudate Gag reflex if client sitting and leaning forward slightly Inform client re procedure
- 29. Blow nose,check nostril patency Rotate Swab inflamed mucosa or exudate Swab must advance into nasopharynx to ensure culture properly obtained
- 30. Ordered to identifyorganisms growing in sputum C&S AFB 3 consecutive, early am Cytology Abnormal lung cancer by cell type 3 early am
- 31. May bedelegated Cough effectively Mucus from bronchus Not Saliva Record ◦ Color ◦ Consistency ◦ Amount ◦ Odor ◦ Document date & time sent to lab.
- 32. No mouthwash/toothpaste- viabilityof microorganisms and alter culture results
- 33. Determines pulmonarydiseases ◦ Bacterial ◦ Fungal ◦ Viral Antigen injected intradermally Injection site circled Instructions not to wash site
- 34. Induration –palpable, elevated, hardened area around site. Edema and inflammation from antigen –antibiotic reaction. Measured in millimeters Reddened flat areas are neg. The elderly freq. display false neg. or false positive TB skin test
- 35. Complete historyrisk factors Symptoms ◦ Weight loss ◦ Night sweats ◦ Hemoptysis ◦ Fatigue Early am sputum for AFB Chest xray
- 36. Insert needle throughchest wall into pleural space Aspirate fluid • Diagnostic • Therapeutic • Biopsy
- 38.
- 39. Culturette/swab Wet/drymethod Nose, throat, wound Review procedure manual & fill in requisitions.
- 40. 1. Explain procedure,gain client’s participation 2. Collect right amt. of specimen at the right time 3. Place specimen in correct container 4. Label container accurately (addressograph), plastic bag
- 41. 5. Complete lab.Req. 6. Place the specimen in the appropriate place for pick up. 7. Document/record specimen sent and anything unusual about the appearance of specimen
- 42. Capillary Puncture Reduces Venipunctures Clients can perform Glucometers Chemical reagent strip Delegated to those instructed in skill if client’s condition stable
- 43. Ordered ac,pc, hs, fasting, before insulin (sliding scale) ? Risks for skin puncture Assess area of skin ◦ Sides of fingers, toes, heels Client’s ability Normal fasting Bld. Sugar 70-120 mg/100ml
- 45. Wash hands,glove Client wash hands, warm water Follow instructions on meter Massage /milk finger or puncture site Antiseptic swab ( allow to dry completely) Wipe away first droplet of blood with tissue/cotton ball
- 46. Dispose oflancet in sharps container Wash hands Check puncture site ◦ Can share reading with client Record results Proceed as indicated by results
- 47. 3 benefits tomeasuring progress and results Shows where we are now Tells if we are heading toward our goal Allows us to make improvements along the way
- 48. Heightens ourawareness Helps us focus on what we value and where we are going Keeps us on track Gives info what is happening along the way and enables us to continue or change depending on desired results
- 49.