Prepared by Mrs / Hamdia Mohammed

SPECIMEN COLLECTION

LEARNING OBJECTIVES:-At the end of this lecture each student should be

able to:1. Define purposes of a specimen

collection.

2. Explain the different type of specimen collection.

3. Identify the universal precautions.

LEARNING OBJECTIVES CONT :-

6. List necessary information included in laboratory request form.

7. Identify nursing responsibilities associated with specimen collection

PURPOSES OF LABORATORY TEST

Assist in the diagnosis of pathological

conditions.

Evaluate the client’s progress and to regulate

treatment.

Prevent or reduce the severity of disease.

STANDARD PRECAUTIONS (UNIVERSAL PRECAUTIONS): THESE ARE BASED ON THREE RULES:-

Rule 1:- Consider ALL patients potentially infectious.

Rule 2:- Assume ALL blood, body fluids and tissues are contaminated.

Rule 3:- Assume ALL used needles or other sharps are contaminated.

TYPE OF SPECIMENS

1- Urine

2- Blood

3- Stool

4- Sputum

5- Wound culture sample

TYPES OF URINE SPECIMEN

Random specimen.

Midstream specimen.

Sterile specimen.

24-Hour urine collection.

Supra pubic needle aspiration of the bladder.

1. RANDOM SPECIMEN (CLEAN VOIDED)

A random routine urine specimen can be

collected with a client voiding naturally.

Uses:-* Routine Urine analysis testing

* PH

* Glucose level

CLIENT’S INSTRUCTION

- The client’s void into a clean urine cup, urinal, or bedpan.

- Client’s drinks a glass of fluid before the procedure about 30 minute.

- A client should be voided before defecating .

DEVICES FOR COLLECTING AND MEASURING URINE

A - Bedpan, fracture pan and Urinal containers for male patient used to collect urine from non ambulatory patientsB - Specimen hat : container that is placed interiorly on the toilet, underneath the seat. Used to collect urine. Specimen cup container

- Placing bedpan against buttocks while patient is on his side.

- Patient raising self in bed for bed pan.

2. MIDSTREAM URINE SPECIMEN

to obtain a specimen relatively free of the

microorganisms growing in the lower

Urethra. UsesUrine culture

CLIENT’S INSTRUCTION

- Cleansing of the external genitalia.

- Allowing the initial portion to escape.

- The clients collects the specimen during the middle portion of voiding .

- Remove specimen container before flow of urine stops and the client finishes voiding into bedpan or toilet .

3. STERILE SPECIMEN

Obtaining urine specimen from an indwelling catheter.

Uses - Urine culture.- Specific gravity: (urine

concentration or the amount of solutes metabolic wastes and electrolytes) present in urine .

OBTAINING A URINE SPECIMEN FROM A PATIENT

WITH AN INDWELLING CATHETER. (A) First, use a swab

moistened with an antiseptic to clean the area where the sterile needle will be introduced.

(B) Then insert the needle and withdraw a specimen of urine.

NURSE GUIDELINES

Washes hands and wear gloves.

Uses a sterile syringe to withdraw urine.

Urine specimen is not collected for culture from a urine drainage bag.

4. 24-HOUR URINE COLLECTIONS

Purpose - To assess the ability of the

kidney to concentrate and dilute urine.

- To determine disorders of glucose metabolism.

5. SUPRAPUBIC ASPIRATION

Indication : Patient with UTI. In neonate. Young infants. Patient whom catheterization is contraindicated. Suspected anaerobic bacteriuria .

GUIDELINES

The client’s should have a full bladder. Properly disinfected of the skin. 19 or 20 gauge needle is passed

through the skin into the bladder . Urine is aspirated into a syringe

BLOOD COLLECTION Wash hands Confirm the identity of the patient Explain the procedure Assemble all necessary equipment Put the patient in comfort position

BLOOD COLLECTION CONT.

Check both arms to select the larger and fuller veins.

Apply the tourniquet. Ask the patient to open and close

his/her fist so their veins become prominent.

Clean the venipuncture site with the alcohol swab in a circular motion.

BLOOD COLLECTION CONT.

Insert the stopper of the first tube to be drawn into the adaptor.

Insert the needle into the vein with the bevel facing upward.

Fill the tube until the vacuum is exhausted.

Place a cotton ball or 4 x 4 square piece of gauze over the site.

BLOOD COLLECTION CONT.

Remove gloves and dispose of in a properly identified biohazard bag or container.

Wash hands thoroughly after phlebotomy .

verify that the information on the sample tubes match is the requisition form

BLOOD CULTURE

Used to detect bacteria or fungi in the systemic circulation.

Performed by sampling peripheral blood using a no-touch or aseptic venipuncture method.

At least 10ml blood should be withdrawn and dispensed into two blood culture bottles, one for aerobic and one for anaerobic culture.

STOOL SPECIMENS

Purpose: 1- To determine the presence of

occulted blood for presence of (ulcers, inflammatory disease or tumors).

2- To analyze for dietary products. 3- To detect the presence of ova and

parasites. 4- To detect the presence of bacteria

or viruses.

PATIENT GUIDELINES FOR STOOL COLLECTION

Defecate in a clean container .

Do not contaminate the specimen

with urine or menstrual discharge.

Void first so urine is not in stool

sample.

Do not place toilet tissue in the

bedpan or specimen container.

Notify the nurse as soon as

possible after defecation and when

specimen is available.

SPUTUM SPECIMEN

# Sputum : Is the mucous secretion from the lung

bronchi, and trachea

# Saliva: the clear liquid secreted by the salivary

glands in the mouth

PURPOSE OF SPUTUM SPECIMENS

For culture

For cytology (to identify structure and pathology of cells such as to identify cancer in the lung

For acid fast bacillus to identify the presence of TB

TIME FOR COLLECTED

- In the morning.

- During postural drainage.

- Use pharyngeal suctioning when a

client

can not cough .

THROAT CULTURE

Sample collected from the mucosa of the oropharynx and tonsillar regions using culture swab

- Puts clean gloves.

- Inserts the swab into oropharynx and runs swab along the tonsils and are on the pharynx that are red or contain exudates.

WHO/CDS/EPR/ARO/2006.1

NASOPHARYNGEAL SWAB

Tilt head backwardsInsert flexible fine-shafted polyester swab into nostril and back to nasopharynxLeave in place a few secondsWithdraw slowly; rotating motion

WHO/CDS/EPR/ARO/2006.1

WOUND CULTURE SAMPLE

1- An aerobic specimen (Superficial Wounds )

2- Anaerobic specimen (Deep

Wounds: or abscess culture )

A. TO COLLECT AN AEROBIC SPECIMEN

Lightly palpate wound edges to detect localized areas of drainage collection

Clean a wound with normal saline to remove skin flora.

Use sterile swab from a culturette tube

TO COLLECT AN AEROBIC SPECIMEN CONT.

If wound edges are separated the nurse gently inserts the tip of the swab into the wound to collect deeper secretions .

TO COLLECT AN AEROBIC SPECIMEN CONT.

After collecting the specimen the nurse returns the swab to the culturette tube, and caps the tube.

Sends the labeled specimen to the laboratory.

B. TO COLLECT ANAEROBIC

SPECIMEN Clean site by wiping with sterile saline

or 70% alcohol.

The nurse uses a sterile syringe tip to aspirate drainage from inner wound.

Afterward the nurse apply a sterile needle to the syringe.

Expels the air from syringe and needle

and place a cork over needle to prevent entrance of air.

LABORATORY REQUEST FORM SHOULD BE INCLUDED THE FOLLOWING INFORMATION:-

The client’s name. Hospital number. Age and gender . Exact nature and source of the specimen. Diagnosis. Date and time of specimen collection. Ordering physician (Test requested or

laboratory test desired). Antimicrobial therapy ( medication as

antibiotic ) .

NURSING RESPONSIBILITIES ASSOCIATED WITH SPECIMEN COLLECTION

Provide client comfort, privacy and safety

Explain the purpose of the specimen

collection

Explain the procedure

Use the correct procedure for obtaining

a specimen

Hand washing & Use aseptic technique.

NURSING RESPONSIBILITIES ASSOCIATED WITH SPECIMEN COLLECTION CONT.

Note relevant information on the

laboratory requisition.

Make sure that the specimen label is

found.

Transport the specimen to the

laboratory promptly.

Report abnormal laboratory finding to

health care provider.

THANK YOU