Urine Specimen
1. Clean-Catch mid-stream urine specimen for routine urinalysis, culture and sensitivity test- Best time to collect is in the morning, first voided urine
- Provide sterile container
- Do perineal care before collection of the urine
- Discard the first flow of urine
- Label the specimen properly
- Send the specimen immediately to the laboratory
- Document the time of specimen collection and transport to the lab.
- Document the appearance, odor, and usual characteristics of the specimen.
- Discard the first voided urine.
- Collect all specimens thereafter until the following day
- Soak the specimen in a container with ice
- Add preservative as ordered according to hospital policy
- Discard the first urine
- Give the patient a glass of water to drink
- After few minutes, ask the patient to void
- Clamp the catheter for 30 min to 1 hour to allow urine to accumulate in the bladder and adequate specimen can be collected.
- Clamping the drainage tube and emptying the urine into a container are contraindicated after a genitourinary surgery.
Stool Specimen
1. Fecalysis – to assess gross appearance of stool and presence of ova or parasite- Secure a sterile specimen container
- Ask the pt. to defecate into a clean, dry bed pan or a portable commode.
- Instruct client not to contaminate the specimen with urine or toilet paper (urine inhibits bacterial growth and paper towel contain bismuth which interfere with the test result.
- To assess specific etiologic agent causing gastroenteritis and bacterial sensitivity to various antibiotics.
- Are valuable test for detecting occult blood (hidden) which may be present in colo-rectal cancer, detecting melena stool
- Hematest– (an Orthotolidin reagent tablet)
- Hemoccult slide– (filter paper impregnated with guaiac)
- *Both test produces blue reaction id occult blood lost exceeds 5 ml in 24 hours.
- Colocare – a newer test, requires no smear
Instructions
- Advise client to avoid ingestion of red meat for 3 days
- Patient is advice on a high residue diet
- Avoid dark food and bismuth compound
- If client is on iron therapy, inform the MD
- Make sure the stool in not contaminated with urine, soap solution or toilet paper
- Test sample from several portion of the stool.
Venipuncture
Pointers
- Never collect a venous sample from the arm or a leg that is already being use d for I.V therapy or blood administration because it mat affect the result.
- Never collect venous sample from an infectious site because it may introduce pathogens into the vascular system
- Never collect blood from an edematous area, AV shunt, site of previous hematoma, or vascular injury.
- Don’t wipe off the povidine-iodine with alcohol because alcohol cancels the effect of povidine iodine.
- If the patient has a clotting disorder or is receiving anticoagulant coagulant therapy, maintain pressure on the site for at least 5 min after withdrawing the needle.
Arterial puncture for ABG test
- Before arterial puncture, perform Allen’s test first.
- If the patient is receiving oxygen, make sure that the patient’s therapy has been underway for at least 15 min before collecting arterial sample
- Be sure to indicate on the laboratory request slip the amount and type of oxygen therapy the patient is having.
- If the patient has just received a nebulizer treatment, wait about 20 minutes before collecting the sample.
Blood specimen
- No fasting for the following tests:
- CBC, Hgb, Hct, clotting studies, enzyme studies, serum electrolytes
- Fasting is required:
- FBS, BUN, Creatinine, serum lipid (cholesterol, triglyceride)
Sputum Specimen
1. Gross appearance of the sputum- Collect early in the morning
- Use sterile container
- Rinse the mount with plain water before collection of the specimen
- Instruct the patient to hack-up sputum
- Use sterile container
- Collect specimen before the first dose of antibiotic
- To assess presence of active pulmonary tuberculosis
- Collect sputum in three consecutive mornings
- To assess for presence of abnormal or cancer cells.
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