Sputum Exam

Sputum the mucous secretion from the lungs, bronchi, and trachea
Sputum is collected for the following purposes:
-for culture and sensitivity to identify a specific microorganism and its drug
sensitivities
-for cytology to identify the origin, structure, function, and pathology of cells.
Specimens for cytology often require serial collection of three early-morning specimens
and are tested to identify cancer in the lung and its specific cell type.
-to assess the effectiveness of therapy
Sputum roduction
!ormally, a patient who coughs long enough almost always produces sputum.
Sputum production is the reaction of the lungs to any constantly recurring irritant. "t also
may be associated with a nasal discharge.
#he nature, onset and duration of the sputum is often indicative of its cause:
-if the sputum is relatively clear in color and less viscous then it can be
considered normal
-if the sputum is thic$, viscous and yellow%green, or rust colored&due to blood' it
is a common sign of a bacterial infection.
- thin, mucoid sputum frequently results from viral bronchitis
-( gradual increase in sputum over time may occur with chronic bronchitis or
bronchiectasis
-in$-tinged mucoid sputum suggests lung tumor.
-rofuse , frothy, pin$ material, often welling up into the throat, may indicate
pulmonary edema.
-)oul smelling sputum and bad breath point to the presence of a lung abscess,
bronchiectasis or an infection caused by fusopirochetal or other anaerobic organism
Sputum examination observations done by the nurse upon collection must be confirmed
by the health care team in the laboratory. "n a normal sputum sample there will be no
disease-causing organisms present. *ften, bacteria that normally live in the mouth will
grow in a sputum culture. #his does not mean that you have a lung or airway infection.
Sputum +ollection
Sputum specimens are often collected in the morning. ,pon the awa$ening, the
client can cough up secretions that have accumulated during the night.
*ther methods of Sputum +ollection include:
Endotracheal (spiration
-ronchoscopic .emoval
-ronchial -rushing
#ranstracheal aspiration
/astric (spiration &done for #-'
!ursing .esponsibilities in sputum collection:
-efore:
-"nform the client the night before the morning of sputum collection and obtain
consent
-offer mouth care so that the specimen will not be contaminated with
microorganisms from the mouth
0uring:
-as$ the client to breathe deeply and then cough up to 1-2 tablespoons &13-45ml'
of sputum
- wear gloves and personal protective equipment to avoid direct contact with the
sputum. 6ear a mas$ capable of filtering droplet nuclei.
-as$ the client to expectorate the sputum into a specimen container. Ensure that
the sputum does not contact the outside of the container.
(fter:
-following sputum collection, offer mouthwash to remove any unpleasant taste.
- label and transport the specimen to the laboratory, the specimen is delivered to
the laboratory within 2 hours by the patient or nurse.
-document the collection of the sputum specimen on the client7s chart. "nclude
the amount, color, consistency, presence of blood, odor, method of collection, and any
discomfort experienced by the client
-runner 8 Suddarth7s #extboo$ of 9edical-Surgical !ursing 12th Edition
:oi;er 8 Erb7s )undamentals of !ursing <th Edition