Specimen Collection in Nursing

Diagnostic Testing

• Pre-test assessment involves focusing on client preparation, assessment, and data collection to determine communication and teaching strategies.
• Assessment and data collection include biologic, psychological, sociological, cultural, and spiritual aspects.
• It's essential to know if the client is pregnant, as special precautions may be necessary or the test may need to be postponed.
• The nurse must know what equipment and supplies are needed for the specific test.

Specimen Collection and Testing

• Nurses are responsible for providing client comfort, privacy, and safety during specimen collection.
• They must explain the purpose of the test, practice aseptic technique, and follow correct procedure.
• Relevant information, such as medication that may affect results, must be noted.
• Specimens must be transported promptly and abnormal findings reported.

Stool Specimens

• The purpose of stool specimens is to determine the presence of occult blood, analyze dietary products and digestive secretion, detect ova and parasites, and detect bacteria or viruses.
• Instructions for stool collection include:
  • Defecating in a clean bedpan or bedside commode
  • Not contaminating the specimen with urine or menstrual discharge
  • Voiding before specimen collection
  • Not placing toilet tissue in the bedpan after defecation
  • Sending the specimen immediately
  • Collecting 2.5 cm / 1 in or 15-30 mL of stool

Urine Specimens

• Clean voided urine specimens are used for routine urinalysis and clean-catch or midstream urine specimens for urine culture.
• The first voided specimen is usually collected in the morning.
• The specimen must be free from fecal contamination.
• The container must be labeled correctly, and the lid placed lightly.

24-Hour Urine Collection

• The purpose of 24-hour urine collection is to assess the ability of the kidneys, determine disorders of glucose metabolism, and measure specific constituents such as albumin, amylase, creatinine, urobilinogen, or certain hormones.
• The collection period is 1-2 hours to 24 hours.
• The client must void and discard the initial urine, then save all urine produced during the collection period.

Urine Testing

• Urine testing includes specific gravity, pH, and the presence of glucose, ketones, protein, and occult blood.
• The principle of urine testing involves dipping the reagent strip into the urine for 2 seconds, removing excess urine, and waiting for exactly 30 seconds before comparing the color with the color chart on the test strip container.

Sputum Specimens

• The purpose of sputum specimens is to identify microorganisms and drug sensitivities.
• The specimen is collected by coughing up 4-10 mL of sputum.
• The nurse must offer mouth care to prevent contamination, wear gloves and PPE, and ensure the sputum does not contact the outside container.

Throat Culture

• A throat culture is used to check for the presence of bacteria or fungal infections in the throat.
• The sample is collected from the mucosa of the oropharynx and tonsillar region using a culture swab.

The Basic Guidelines for Specimen Collection

• Specimens must be collected at the best time possible, such as early morning sputum for AFB culture.
• Appropriate collection devices, such as sterile, leak-proof specimen containers, must be used.
• Expiration dates must be checked before inoculating the collection device.
• The test request form must be filled out fully, and the specimen labeled properly.
• There must be a suitable time between collection of the specimen and delivery to the lab.

The Role of Nurses in Specimen Collection

• Nurses are responsible for ensuring appropriate collection of samples, precise sample identification, and selecting suitable supplies for collection.
• They must also ensure timely transfer of the specimen to the lab and interact with patients during the process.