In Practice: Collecting Clean-Catch or Midstream Urine Specimens *Refer to Nursing Care Guidelines Label container Instruct client to cleanse the urethral area thoroughly Instruct female client to cleanse from front to back and to cleanse each side with a separate wife, saving the last for the urethral area itself Instruct the male client to cleanse the penis using a circular motion and going outward from the urethral meatus Instruct client to then void a small amount into the toilet and then void into the sterile container (catching the midstream urine), then void the remainder into the toilet
Nursing Alert Be aware that false-positive results may occur with guaiac tests. “False-positives” can be caused by the client having consumed large amounts of rare red meat or certain foods, such as radishes, tomatoes, beets, horseradish, or some melons. In addition, the client should not take more than 250 mg per day of vitamin C and should not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) for 3 days before the test. Usually, three separate specimens are collected on three separate days before a determination of positive or negative is made. If test results are repeatedly positive, additional examinations are necessary.
Nursing Alert The sputum specimen is considered highly contaminated. Treat it with caution. Paper tissues used by any client also are considered contaminated. Dispose of them properly. Wear gloves when handling tissues and sputum specimens and when providing nursing care if the client is coughing up sputum. Goggles and a mask or full face shield may be necessary to protect the nurse from droplet secretions, particularly if the client is coughing or spitting. (A “spit shield” is also available. This is a net-type device that is placed over the client’s head so he or she cannot spit at others.)