 Collecting and Testing Specimens Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

 Ordered by doctors, specimens (samples) are collected and tested to prevent, detect, and treat disease.  Most specimens are tested in the laboratory. o All specimens sent to the laboratory require requisition slips.  Some tests are done at the bedside. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 2

 Urine specimens are collected for urine tests.  Random urine specimen is used for a routine urinalysis (UA). o It is collected any time during a 24-hour period. o Many people can collect the specimen themselves. Weak and very ill persons need help. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 3

 Midstream specimen (clean-voided specimen or clean- catch specimen) o The perineal area is cleaned before collecting the specimen. o To collect the specimen: The person starts to void into a device. The person stops the urine stream. A sterile specimen container is positioned. The person voids into the container until the specimen is obtained. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 4

 The 24-hour urine specimen o All urine voided during a 24-hour period is collected. o Urine is chilled on ice or refrigerated during this time. o A preservative is added to the collection container for some tests. o The person voids to begin the test with an empty bladder. Discard this voiding. Save all voidings for the next 24 hours. o The test is restarted if: A voiding was not saved. Toilet tissue was discarded into the specimen. The specimen contains stool. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 5

 To collect a urine specimen from an infant or a child who is not toilet-trained, a collection bag (“wee bag”) is applied over the urethra.  Voiding on request is hard for toilet-trained toddlers and young children. o Potty chairs and specimen pans are useful. o Remember to use terms the child understands. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 6

 The doctor orders the type and frequency of urine tests. The nurse may ask you to do these simple urine tests. o Testing for pH Urine pH measures if urine is acidic or alkaline. A random urine specimen is needed. o Testing for glucose and ketones The diabetic person may have sugar (glucose) in the urine and ketones in the urine. Tests for glucose and ketones are usually done 4 times a day—30 minutes before each meal and at bedtime. The doctor uses the test to make drug and diet decisions. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 7

o Testing for blood Injury and disease can cause hematuria (blood in the urine). Sometimes blood is seen in the urine. At other times, it is unseen (occult). A random urine specimen is needed.  Using reagent strips Do not touch the test area on the strip. Dip the strip into urine. Compare the strip with the color chart on the bottle. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 8

 Straining urine o A stone (calculus) can develop in the kidney, ureter, or bladder. Stones (calculi) vary in size. Stones causing severe pain and urinary system damage may require removal by medical or surgical procedures. Some stones pass through urine. All of the person’s urine is strained. Passed stones are sent to the laboratory. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 9

 Stools are studied for fat, microbes, worms, blood, and other abnormal contents. o Bleeding may occur in very small amounts Stools are tested for occult (hidden) blood. Stools are tested for occult blood to screen for colon cancer and other digestive disorders. Occult blood test kits vary. Follow manufacturer’s instructions. o Urine must not contaminate the stool specimen. The person uses one device for voiding and another for a BM. o Some tests require a warm stool. The specimen is taken at once to the laboratory or storage area. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 10

 Mucus from the respiratory system is called sputum when expectorated (expelled) through the mouth. o Sputum is not saliva.  Sputum specimens are studied for blood, microbes, and abnormal cells. o The person coughs up sputum from the bronchi and trachea. o It is easier to collect a specimen in the morning. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 11

 Blood glucose testing is used for persons with diabetes. o The doctor uses the results to regulate the person’s drugs and diet.  Capillary blood is obtained through a skin puncture. o A drop of blood is collected. o A fingertip is the most common site for skin punctures. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 12

 To perform a skin puncture: o Inspect the puncture site carefully for signs of trauma and skin breaks. o Do not use swollen, bruised, cyanotic, scarred, or calloused skin. o Use the side toward the tip of the middle or ring finger. o You use a sterile, disposable lancet to puncture the skin. The person feels a brief, sharp pinch. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 13

 Using a reagent strip, a glucometer (glucose meter) measures blood glucose. o You apply a drop of blood to a reagent strip. o The blood glucose level appears on the screen. o Many types of glucometers are available. You learn to use your agency’s device. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 14