Lesson (13): Collection of Specimens

Lesson (13): Collection of Specimens

Learning Objectives:
After successful completion of this lesson, the students must be able to:
1) Identify different types of collection specimens.
2) Demonstrate different types of collection specimens.
I- Collection of urine specimen for infants
Purposes:
1- To aid in diagnosis.
2- To determine the progress of patient's condition
Types of collecting urine specimen
a- Single specimen (1st. void in the morning)
b- 24 hours specimen.
A. Single specimen:
Equipment:
- Toilet soap, water and a towel
- A bag specimen
- Adhesive tape
- Specimen bottle
- Completed lab form
- Kidney tray or paper bag
- Cotton balls

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 Lesson (13): Collection of Specimens

Learning guide for collection of urine specimen

(SINGLE SPECMINE)
Getting ready
1. Wash hands
2. Prepare the needed equipment .(toilet soap,
water , towel, disposable urine bag, specimen
container, cotton ball, kidney basin or paper bag,
requisition form and completed lab form)

Plastic disposable urine collector

3. Explain the procedure to the child or his/her parent.
4. Provide privacy by closed curtains around the bed.
During The Procedure
1. Position the child (so that genitalia are exposed by placing him or her on the
back with legs in frog- like position. Assistance may be needed to hold the legs
of the young child in proper position
2. Wear gloves
3. Cleanse the genitalia :
 For female, using cotton balls, dip into cleansing agent, wipe labia majora
from top to bottom (clitoris to anus) only once with each cotton ball. Repeat
this once more. Wipe again with clean water. The spread labia apart with one
hand while wiping the labia minora in the same manner with other hand. Dry
the area.
 For male, wipe tip of penis in circular motion down towards the scrotum. Be
certain to retract foreskin if present. Wipe first with cleansing agent 2-3 times,
then clear water. Dry the area or you can cleanse the genitalia with soap and
water, and rinse thoroughly and dry.

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 Lesson (13): Collection of Specimens

4. Apply collecting bag firmly so that the opening is exposed to receive urine:
 For male: Insert the penis inside the bag.
 For female: Stretch perineum taut during application. Apply the plastic
disposable urine collector
 Check the child frequently (30-45 minutes) to see if he or she has voided.
When the child has voided, remove bag gently, cleanse area and reapply diaper
to the child.
5. Pour specimen into proper collection container
6. Label the specimen and send it to the lab immediately to prevent
decomposition of urine.
Label should include: patient's name, pediatric unit, diagnosis & type of analysis
required.
After the Procedure
1. Wash hands and dispose equipment.
2. Record:
 Time specimen was collected
 Color, of urine (cloudy, clear, presence of any sediment).
 Amount of urine voided
 Nature of the test which the specimen was collected
 Condition of the skin

B- 24 hours specimen
It is extremely important diagnostic test because it reveals how the kidney
adjusts to changing physiologic needs over a long period. Substances excreted
by the kidney are not excreted at the same rate or in the same amount during
the different periods of day and night. Therefore, a random urine specimen
doesn't accurately represent the processes taking place over a 24 hours.

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 Lesson (13): Collection of Specimens

Procedure Rationales
1. The individual voids and discards the
urine already in the bladder. All urine
starting with the next voiding is collected
for the next 24 hours.
2. Put it into a large collection bottle.
3. Add a preservative to the container or To prevent breakdown of
refrigerate it. urinary components.

2- Collection of stool specimen

Purpose:
- Help to diagnose some diseases or detecting parasites
- To know progress of patient's condition.
Single specimen:
1- Feces is collected into the container using a spatula from bed pan or napkin.
2- Stool specimen for culture and sensitivity is sent to laboratory in a sterile
container.
Equipment:-
- Waxed jar with cover
- Tongue blade.
- Label
Method Rationales
1- Wash hands
2- Separate stool from diaper by tongue - Fresh stool is required
blade and place it in the waxed jar and So that stool will not be oxidized.
cover it, then discard the tongue blade.
3- Label the jar.

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 Lesson (13): Collection of Specimens

4- Send specimen immediately to the lab or - In order not to allow

refrigerate it. microorganism to grow up.
Learning guide for collection of stool specimen
Procedure
Getting ready
1.Wash hands
2. Prepare the needed equipment .( waxed jar with cover, tongue blade, label)
3. Explain the procedure to the child or his/her parent.
4. Provide privacy by closed curtains around the bed.
During The Procedure
1.Wear gloves
2. Remove solid diaper from the child, clean perineal area, apply clean diaper and leave
the child comfortable.
3. Separate stool from diaper by tongue blade and place it in the waxed jar and cover it.
4. Label the specimen and send it to the lab immediately. Label should include: - child's
name, pediatric unit, diagnosis & type of analysis required.
After the Procedure
1. Wash hands and dispose equipment.
2. Record:
 Time specimen was collected
 Color , amount and consistency of stool (note any foul smell)
 Nature of the test which the specimen was collected
3- Collection of sputum specimen
Purpose:-
- Help in diagnosis of some diseases
- To know progress of patients condition
Method
a- From a young child.

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 Lesson (13): Collection of Specimens

1- When the sputum is coughed up, wipe the sputum with cotton applicator
and dropped into a clean test - tube, close the test – tube with a cotton plug.
b- From an older child:
1- The child's mouth is rinsed with water early in the morning
2- Ask the child to cough & expectorate his sputum into a laboratory container.
N.B: for coughing and expectorating the specimen, position the child in the
semi- Fowler position, and sitting on the side of the bed or in a chair, or
standing.
Equipment needed:
- Sterile waxed jar with cover
Method Rationales
1- Wash hands
2- Allow patient to cough deeply to - Not to get saliva
get rid of sputum in the waxed jar
& cover it.
3- Send specimen immediately to - If not possible refrigerate it so that
lab microorganism does not grow up.

Learning guide for collection of sputum specimen

Procedure
Getting ready
1. Wash hands

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 Lesson (13): Collection of Specimens

2. Prepare needed equipment (sterile waxed jar with cover or sterile test tube,
cotton applicator in case of the young child)
3. Explain procedure to the child and or his parent
During the procedure
1. From a young child, when sputum is coughed up, Wipe the sputum with
cotton applicator
 Dropped cotton applicator into a clean test tube
 Close the test tube with a cotton plug
2. From the older child,
The child’s mouth is rinsed early in the morning
 Wash hands
 Allow child to cough deeply and expectorate his sputum into waxed jar and
cover it. Not to get saliva.
3. Label the specimen with the child’s name, and send it to the lab
immediately.
AFTER THE PROCEDURE
1. Wash hands and dispose equipment
2. Record: The amount of the sputum
 Characteristics as color
 Reaction of the child

4- Collection of discharges or pus using swabs:

Swab: is a sterile dressed applicator contained in a plugged tube used to collect
material for bacteriological examination from the body surface & inside
orifices.

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 Lesson (13): Collection of Specimens

General principles:
1- Restrain the child if unable to cooperate.
2- A good light is essential.
3- The swabs should not touch anywhere except the area from where swab is
collected.
4- Collect the swab before any antiseptic or antibiotics are applied to the area.
Throat swab:
Requirements: - Tray containing:-
1- Torch light. 2- Tongue depressor.
3- Swab 4- Kidney tray 5- Laboratory form
Procedure
1- Explain to the child and parents
2- Restrain the child if needed & make him sit comfortably facing the person
who takes the swab.
3- If the child is not cooperative, the thumb placed on the chin and gently
pressed down to lower the jaw.
4- The tongue is depressed with a spatula.
5- Collect specimen from the tonsil area-using swab & sent to the laboratory
immediately.
6- Parents should be encouraged to take part in the care of the child and
reassure them.
Prepare for discharge:
- Teach them the procedures to be continued at home.
- Arrange for community health nurse's service if needed.
- Give appointment for next visit.

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 Lesson (13): Collection of Specimens

5-Collection of capillary blood specimen

Learning guide for collection of capillary blood specimen
Procedure
Getting ready
1. Wash hands
2. Prepare the needed equipment .(disposable lancets or microlaricet,
alcohol swabs, sterile gauze pads, gloves, warm washcloth, specimen
container, labels, requisition forms
3. Prepare the child using age- appropriate language.
4. Select the site of capillary puncture, heel for infant under 6 months of
age and younger, and Finger and ear lobe for older children than 6
months of age.
During the procedure
1. Warm the site before proceeding using the warm washcloth
2. Wear gloves
3. Cleanse the site of puncture with the across the fingerprint halfway,
between the center of the ball of the finger and its side, use the third, or
ring finger of the non-dominant hand. Don’t use a bruised, edematous
or abraded finger and avoid any previously used site.
4. If using the heel
 Cleanse the heel with antiseptic solution and dry.
 Encircle the heel with the thumb and index finger and blood is ‘milked’
centrally by gentle squeezing with the rest of the hand, the heel will
appear ‘flushed’ when ready for capillary puncture
 Grasp a lancet firmly and introduce through the skin into the
subcutaneous tissue and quickly remove from incision.
5. Blot of the first drop of blood with a sterile gauze pad
6. Collect the blood into the container

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 Lesson (13): Collection of Specimens

7. Press the dry sterile gauze over the incision and hold firmly 2-3
minutes
8. Label the specimen with the child’s name, and send it to the lab
immediately.
After the Procedure
1. Wash hands and dispose equipment.
2. Record: The amount of blood collected
 The site of puncture
 Type of analysis required
 Reaction of the child

NOTE
Poor peripheral perfusion, local infection, bruising, foot anomalies and
injuries are absolute contraindications to performing finger sticks or heel
.sticks

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