Specimen Collections

Urine Specimens Random specimen Clean-voided or midstream specimen Sterile specimen Timed urine specimen Urine Collection in Children

Urine Specimens Clean catch midstream Explain procedure Open kit – surgical asepsis Female: clean front to back, hold labia apart for collection Male: cleanse end of penis, circular motion Initiate stream, then collect specimen

Clean catch midstream (cont.) Urine Specimens Clean catch midstream (cont.) Label on specimen Biohazard bag Requisition on outside of bag

Sterile (from catheter) Urine Specimens Sterile (from catheter) Clamp below port Wipe port with antimicrobial swab Insert needle (3ml; 23-25g) Aspirate 3-5 ml. Transfer urine aseptically to container Label, bag, requisition

Urine Specimens Timed Specimens creatinine clearance protein quanitification adrenocortical steroids

Timed Specimens (cont.) Urine Specimens Timed Specimens (cont.) Begins: after client voids Discard sample and indicate starting time on: 1) Collection container 2) Lab requisition slip 3) Bathroom or bedside

Timed Specimens (cont.) Urine Specimens Timed Specimens (cont.) Collect in clean container Empty into large container immediately On ice or preservative Void at end of time & send to lab

Collection in children Urine Specimens Collection in children Clear plastic single use bags Do not squeeze urine from diaper

Common tests done on urine UA = urinalysis Specific Gravity Urine Culture

Urinalysis (normal values) pH (4.8-8.0) average 6.0 Protein (none) Glucose (none) Ketones (none) Blood (up to 2 RBC’S) Specific gravity (1.010-1.025) WBC’S (0-4) Bacteria (none) Casts (none)

Fecal Specimens Ch. 45 Hemacult or guaiac Ova and Parasites Culture and Sensitivity

Indications for collection: Fecal Specimens Indications for collection: Tumors Hemorrhage Infection

Fecal Specimens Collection: Pt. instruction Can not be mixed with water or urine 1 inch formed stool 15-30 ml liquid, diarheal stool Avoid delays in sending Ova and Parasites: require keeping warm

Fecal Specimens Guaiac Fecal occult blood FOBT Hemacult – most common Microscopic amounts of blood Screening for: colon ca, anticoagulants, GI disorders

Sputum Specimens Culture Cytology AFB = Tuberculosis

Sputum Specimens Collection: Teach to cough effectively Keep inside of container sterile Document: color, consistency, amt, odor Early morning specimen

GLUCOMETER Blood glucose Normal values Indications for checking

Review Questions In a timed urine collection, any missed specimens will extend the end time. TRUE OR FALSE?

Review Questions When collecting a urine specimen from an infant – it is OK to squeeze urine from the diaper? TRUE OR FALSE?

Review Questions A urine culture can be obtained from a urinalysis TRUE OR FALSE?

Review Questions If a client is taking iron supplements, the hemacult test will show a false positive. TRUE OR FALSE?

Review Questions When collecting a stool specimen for ova a parasites, the nurse should refrigerate the specimen untill it can be transported to the lab TRUE OR FALSE?

Review Questions When is the best time to obtain a sputum specimen?