Unit 8 Specimen Collection PDF

‭SPECIMEN COLLECTION‬ ‭Learning Outcomes‬ ‭After completing this topic students will be able to:‬ ‭.‬ 1 ‭ iscuss the nursing responsibility for specimen collection.‬ D ‭2.‬ ‭Explain the rationale for the collection of each type of specimen.‬ ‭3.‬...

‭SPECIMEN COLLECTION‬ ‭Learning Outcomes‬ ‭After completing this topic students will be able to:‬ ‭.‬ 1 ‭ iscuss the nursing responsibility for specimen collection.‬ D ‭2.‬ ‭Explain the rationale for the collection of each type of specimen.‬ ‭3.‬ ‭Describe how to collect stool specimens.‬ ‭4.‬ ‭Compare and contrast the different types of urine specimens.‬ ‭5.‬ ‭Describe how to collect sputum and throat specimens.‬ ‭6.‬ ‭Verbalize and demonstrate the steps used in:‬ ‭i.‬ ‭Obtaining a capillary blood specimen to measure blood glucose.‬ ‭ii.‬ ‭Collecting a urine specimen for culture and sensitivity by clean catch.‬ ‭A.‬ ‭INTRODUCTION‬ ‭‬ ‭Diagnostic and laboratory tests – to provide information about clients.‬ ‭B.‬ ‭DIAGNOSTIC TESTING‬ ‭1.‬ ‭Pre-test Assessment‬ ‭-‬ ‭Focus on client preparation‬ ‭-‬ ‭Assessment and data collection (e.g., biologic, psychological, sociological,‬ ‭cultural and spiritual) assist nurse in determine communication and teaching‬ ‭strategies‬ ‭-‬ ‭Important to know if the pt is pregnant, because special precaution may be‬ ‭necessary or the test may need to postponed due to pregnant‬ ‭-‬ ‭Need to know what equipment/supplies are needed for specific test‬ ‭-‬ ‭Common question;‬ ‭⮚‬ ‭What type of sample will be needed and how will it be collected?‬ ‭⮚‬ ‭Does the client need to stop oral intake for a certain number of hours‬ ‭prior to the test?‬ ‭⮚‬ ‭Does the test include administration of dye (contrast media) and, if so, is‬ ‭it injected or swallowed?‬ ‭⮚‬ ‭Are fluids restricted or forced?‬ ‭⮚‬ ‭Are meds given or withheld?‬ ‭⮚‬ ‭How long is the test?‬ ‭⮚‬ ‭Is a concerned form required?‬ ‭-‬ ‭ nswers these types of questions can avoid costly mistake and reduce‬ A ‭inconvenience to all the healthcare team‬ ‭-‬ ‭Laboratory act as resources information‬ ‭2.‬ ‭Intra-test‬  ‭-‬ F‭ ocus on specimen collection and performing /assisting with certain diagnostic‬ ‭test‬ -‭ ‬ ‭Nurses use the standard precautions and sterile technique‬ ‭-‬ ‭During the procedure, nurse provides emotional and physical support while‬ ‭monitoring (e.g., vital signs, pulse oximetry, ECG)‬ ‭-‬ ‭Nurse ensures correct labelling, storage, and transportation of the specimen to‬ ‭avoid invalid test results‬ ‭3.‬ P ‭ ost-test‬ ‭-‬ ‭Focus on nursing care of the client and follow-up activities and observations‬ ‭-‬ ‭Nurse compares the previous and current test results and modifies nursing‬ ‭intervention as needed‬ ‭-‬ ‭Report the result to appropriate team members‬ ‭-‬ ‭The National Patient Safety Goals Identify the importance of reporting critical‬ ‭results of test and diagnostic procedures‬ ‭C.‬ ‭MEASURE CAPILLARY BLOOD GLUCOSE‬ ‭‬ ‭To measure – current blood glucose level‬ ‭a)‬ ‭Responsibility‬ ‭-‬ ‭Clean the site with antiseptic and dry completely before prick‬ ‭-‬ ‭Capillary blood specimen – obtained from lateral aspect or side of the‬ ‭finger in adults‬ ‭b)‬ ‭Skills:‬ ‭i.‬ ‭Purpose‬ ‭ii.‬ ‭Assessment‬ ‭iii.‬ ‭Planning‬ ‭iv.‬ ‭Equipment‬ ‭v.‬ ‭Implementation‬ ‭vi.‬ ‭Evaluation‬ ‭D.‬ ‭SPECIMEN COLLECTION AND TESTING‬ ‭a)‬ ‭Responsibilities‬ ‭i.‬ ‭Provide client comfort, privacy, and safety‬ ‭ii.‬ ‭Explain the purpose‬ ‭iii.‬ ‭Practice aseptic technique and correct procedure‬ ‭iv.‬ ‭Note relevant information : medication affect results‬ ‭v.‬ ‭Transport specimen – promptly‬ ‭vi.‬ ‭Report abnormal – finding‬ ‭1.‬ ‭Stool Specimens‬ ‭a)‬ ‭Purpose;‬ ‭i.‬ ‭To determine presence – occult blood‬ ‭ii.‬ ‭To analyze – dietary products & digestive secretion. Eg; excessive fat;‬ ‭decreased bile‬ ‭iii.‬ ‭To detect – ova & parasites‬ ‭iv.‬ ‭To detect – bacteria / viruses‬ ‭b)‬ ‭Instruction to give;‬ ‭i.‬ ‭Defecate in a clean bedpan/ bedside commode‬ ‭ii.‬ ‭Do not contaminate – specimen : urine/ menstrual discharge‬ ‭iii.‬ ‭Void before – specimen collection‬ ‭iv.‬ ‭Do not place toilet tissue – bedpan after defecation‬ ‭v.‬ ‭Send specimen immediately‬ ‭vi.‬ ‭Amount @ 2.5 cm / 1 in or 15 -30mls‬ ‭2.‬ U ‭ rine Specimens‬ ‭a)‬ ‭Clean voided urine specimen‬ ‭i.‬ ‭To collect – clean voided specimen for routine urinalysis, clean-catch or‬ ‭midstream urine specimens for urine culture‬ ‭ii.‬ ‭First voided specimen – morning‬ ‭iii.‬ ‭Amount – 10mL urine‬ ‭iv.‬ ‭Specimen must be free – fecal contamination‬ ‭v.‬ ‭Discard – toilet tissue‬ ‭vi.‬ ‭Put the lid lightly – container‬ ‭vii.‬ ‭Clean contaminated area – disinfectant‬ ‭b)‬ ‭Skill‬ ‭i.‬ ‭ urpose‬ P ‭ii.‬ ‭Assessment‬ ‭iii.‬ ‭Planning‬ ‭iv.‬ ‭Equipment‬ ‭v.‬ ‭Implementation‬ ‭vi.‬ ‭Evaluation‬ ‭TIME URINE SPECIMEN / 24 hours urine collection‬ ‭‬ ‭Period of time : 1-2 hrs to 24 hrs to collect urine‬ ‭1)‬ ‭Purpose;‬ ‭i.‬ ‭To assess – ability – kidney‬ ‭ii.‬ ‭To determine disorder – glucose metabolism for DM pt‬ ‭iii.‬ ‭To determine levels – specific constituents – eg; albumin, amylase, creatinine,‬ ‭urobilinogen, or certain hormone (estriol/corticosteroids)‬ ‭iv.‬ ‭Obtain – specimen container‬ ‭v.‬ ‭Provide – clean receptacle – collect urine‬ ‭vi.‬ ‭Post signs – client’s chart‬ ‭vii.‬ ‭At the start – collection period – client void & discard – urine‬ ‭viii.‬ ‭Save all urine produced‬ ‭ix.‬ ‭At the end – collection period, instruct – to completely empty – bladder and save‬ ‭x.‬ ‭Record collection – specimen, time started & completed‬ ‭URINE TESTING‬ ‭‬ ‭Tests : specific gravity, pH, presence of – glucose, ketones, protein, occult blood‬ ‭Principle‬ ‭‬ ‭ ip end of specimen reagent strip in to urine for 2 sec‬ D ‭‬ ‭Remove excess urine by tapping the strip against the specimen container rim‬ ‭‬ ‭Wait for exactly 30 sec‬ ‭‬ ‭Compare its colour with the colour chart on the test strip container‬ ‭‬ ‭Ignore color changes that occur after 30 sec‬ ‭SPUTUM SPECIMENS‬ ‭1. PURPOSE‬ i‭.‬ F‭ or culture and sensitivity – identify a specific microorganism & drug sensitivities.‬ ‭ii.‬ ‭For cytology to identify the origin, structure, function, and pathology of cells. Specimens –‬ ‭cytology often require serial collection of three earlymorning specimens and are tested to‬ ‭identify cancer in the lung and its specific cell type.‬ ‭iii.‬ ‭For Acid-fast bacillus (AFB), which also requires serial collection, often for 3 consecutive‬ ‭days, to identify the presence of tuberculosis (TB).‬ ‭iv.‬ ‭To assess – effectiveness of therapy.‬ ‭2. Responsibility‬ i‭.‬ ‭ ffer mouth care – specimen will not – contaminated with microorganisms from – mouth.‬ O ‭ii.‬ ‭Ask – client to breathe deeply & cough up 4 to 10 mL – sputum.‬  ‭iii.‬ ‭ ear gloves & PPE - suspected TB iv. Ensure sputum does not contact – outside container.‬ W ‭(Disinfect if contaminated )‬ ‭iv.‬ ‭Offer mouthwash following sputum collection vi. Label & transport – specimen –‬ ‭immediately – laboratory.‬ ‭v.‬ ‭Document – client chart ( amount, color, consistency: thick, tenacious, watery; hemoptysis,‬ ‭odor,‬ ‭THROAT CULTURE‬ ‭∙ A sample – collected from – mucosa of – oropharynx & tonsillar region using a culture swab‬ ‭The Basic Guidelines For Specimen Collection‬ ‭‬ S‭ pecimens need to be collected at the best time possible, such as early morning sputum for‬ ‭AFB culture.‬ ‭‬ ‭Use appropriate collection devices like sterile, leak-proof specimen containers for collecting‬ ‭samples.‬ ‭‬ ‭Expiration dates need to be checked before inoculating collection device.‬ ‭‬ ‭Fill out the test request form fully and label the specimen properly.‬ ‭‬ ‭Maintain an appropriate time between collection of the specimen and delivery to the lab.‬ ‭The Role of Nurses in Specimen Collection:‬ ‭‬ E‭ nsuring appropriate collection of samples‬ ‭‬ ‭Precise sample identification‬ ‭‬ ‭Making sure all selected supplies are suitable for collection‬ ‭‬ ‭Timely transfer of specimen to the lab‬ ‭‬ ‭Patient interaction‬ ‭Common Specimen Collections:‬ ‭1.‬ T‭ hroat swab culture‬ ‭To check the presence of a bacteria or fungal infection in the throat, a diagnostic test‬ ‭called a throat swab culture is conducted. In this test, a sample of mucus is collected‬ ‭on a cotton-tipped applicator and is placed on a special cup that allows infections to‬ ‭dwell. Common infections include pneumonia, whooping cough, and tonsilitis‬ ‭2.‬ S‭ putum specimen and culture‬ ‭In this laboratory analysis, a sample of material is expelled from the respiratory‬ ‭passages to determine pathogen presence. It generally takes a good 2-3 days to‬ ‭collect the specimen, as it is very difficult for a patient to cough up enough sputum‬ ‭at one time‬ ‭3.‬ ‭Stool specimen and culture‬  S‭ tool cultures include the process of growing organisms existing in the feces to‬ ‭identify any disease-causing bacteria. The most common is the parasites and ova test‬ ‭to detect the presence of parasites such as amoebas or worms.‬ ‭4.‬ U ‭ rine specimen and culture‬ ‭Physical, chemical and microscopic examination of urine is referred to as urinalysis. It‬ ‭generally involves a number of tests to analyze various compounds thoroughly that‬ ‭pass through the urine. The color, density, and odor of the urine are all considered to‬ ‭reveal the individual’s health status‬