NAIL CARE

&
SPECIMEN COLLECTION
-Kuheli mondal
Introduction:
• Prompt and correct collection of client's diagnosis, t
reatment and recovery. Most often the nurse is the
sole responsible person for the collection of specim
ens. In correct results can mislead the diagnosis an
d treatment. Hence the nurse has to be careful in c
ollection and transportation of specimens in an app
ropriate manner.
Definition:
• A specimen may be defined as a small
quantity of a substance or object. Whi
ch shows the kind and quality of the
whole(sample)
Purpose:
• To know the proper method of collection of
specimen
• To understand the importance of specimen
collection
• To develop skill in collection of different spe
cimen
• To develop determine the variation from no
rmal to abnormal sickness
Indication:
• For cultore sensitivity to identify a speci
fic organism and its drug sensitivity
• For cytology to identify the origin, functi
on and pathology of cells
• For assessment of the effectiveness of t
herapy
Type of examination:
• The specimens colletted for veriou
s examination are given --
Specimen and type of examin
ation
Specimen Type of examination
• Urine • Collection of mild strea
m urine
• Rutine microscope cult
ure
• 24 hours urine
• Pregnancy test
• Double voided specime
n
• Stool • Routine microscopic cul
ture
• Occult blood test
• Ovam and cyst
• Sputum • Microscopic acid fast ba
cili
• Culture
• Blood • Collection of blood by s
kin and vein punctore
• Red cell, white cell, pala
telet count
• Blood smear and leukoc
yte count
Nurses responsibility in co
llection of specimens
1.Collection to be done in specific container that is -
-clean
-sterile
-specific gravity for specific tests
-labelled for clear indientification
• 2. All specimen must be collected fresh usually
in the morning
• 3. Follow the correct method of collection
• 4. All specimen should be well labelled
• 5. For female patient urine and stool specimen
s should be avoided during mensturation. If it
has to be collected put tempor in vagina befor
e collection of specimen.
Sample of the lable
Collection of urine specime
n
•Steps of procedure:
• Collection of midstream urine for cultur
e and routine examination
Nurses action
• Assess clients mobility and
explain in the patient haw a
nd what specimen to be col
lected.
• Provide privacy to the client
• Wash hands and wear golv
es
• Give a bed pan to the bed ri
dden patient
Rationale
• Determine the level assistan
ce required clarity doubts of
protecte the client co-opera
tion.
• Helps the client to relax pro
duce specimen easily
• To protect the nurses hands
to reduce risk transmission
of infection
• To procure the sample
• Assist on allow the client to
wash the perineum and coll
ect specimen
• Male: Hold penis and retract
the foreskin and using a circul
ar motion clear the penis mov
ing from centre to peripheral
• Female: seperate labia mi
nora with thumb and for fin
ger and clean the area from
top to bottom, centre to per
iphary
• Clean area from leaat c
ontamination to the are
a of greatest contamina
tion
• Ckean area from least c
ontamination to the are
a of greatest contamina
tion
• After initiating urine str • Inital steam fluhes out t
eam pass the urine to t he micro organisms the
he specimen bottle and accumotation at the uri
collect 30-60 ml of urin nery meatus
e • To prevent spillage of u
• Remove the specimen c rine and contamination
ontainer before the clie
nt empties the bladder
and replace the topon t
he specimen container
• Remove the bed pan an • Promotes a relaxing env
d make the patient com irunment
fortable • Bacteria grow quickly in
• Transport the specimen urine
to the laboratory witn 1 • Recording avoids duplic
5 min ates on of work
• Record data and the tim
e of collection of speci
men in the nurses recor
d
Urine specimen from an indwelling cut
heter
Sterile urine specimen may be attained by useing
• Clean catch technique
• Catheterising the cliant
• Obtaining the specimen from the indwelling cathet
er already in place and specimen collected in the ca
theter in self
24 hour urine specimen
• For a 24 hr specimen all urine voided in a 24 hr peri
od. The collection is initiated at special time and th
e client is assist to empty his bladder at that time. T
he urine is discorded and aften this all urine collect
ed in receptable for next 24 hr. At the time and the
collection is noted and preservation are added e. g
basic acid, con. Hcl, formalin, chlorofrom etc. To pr
event decomposition and multiplication of bactermi
a. Next it is labelled and send to lab.
Double voided specimen
• Freshly voided urine is needed to determine the for
m. The client is instructed to clear all urine, next he
is instructed to drink a glass of water and specimen
collected 30 min after taking water
Urine for pregnancy test
:
• Urine is collected aften 14 days of missed period pr
eferably at morning.
Collection of stool specime
n:
Steps of procedure:
Steps
• Explain the procedure to th
e client. What the specimen
is requried and the reason
• Ask the client to pass urine
• Ask the patient to defecnce
into the clean bed pan. Do
not collect the specimen fro
m toilet bowl
• Wear gloves
Rotionale
• For betten co operation a
nd to reduce anxiety
• Result of analysis may be i
naccurate
• Its easy to collect and tran
sfer stool in to the specim
en container
• To avoid contamination a
nd infection
• With a clean nooden spat • Fresh specimen produc
ula lift up a portion of the es most accurate result
stool 15-30ml and place i
n specimen container
• The specimen with blood
muscus or pus is sent to t
he laboratory immediatel
y
• The specimen with blood
muscus or pus is sent to t
he laboratory
Stool for ova and parasite:
• Stool for ova and parasites is collected to detect int
estinal infection coused by parasites and then ova.
The client should be instructed ti avoid drugs and in
structed that three specimen are taken every other
day or every third day
Stool culture:
• Stool culture are perforned to identify pathogenic o
rganism present in a tract stool should be collected
using sterile container in sterile technique. It may b
e collected for three consecutive days.
Stool for occult blood:
• Stool examination for occult blood help to defect GI
bleeding and early diagnosis of colloidal cancer
• The patient may be instructed to eat high fiber diet
for 48 to 72 hr before collection of the stool specim
en. A total of three stool specimen over consecutiv
e days is collected.
Stool for lipids :
• Diatory lipids are almost completely absorbed in th
e small intestine. Execssive secration of faccal fals m
ay occur in verious digestive and absorptive disorde
r. The client should be instructed to eat a high fat di
et and days before the test and during the collectio
n of stool
Collection of sputum specimen:
Procedure:-

• The patient should be instructed to cough up the m

orning specimen in the container
• The specimen should be contain lumps or mucoid s
putum and as little saliva as possible by deep deep
coughing
• The specimen may have to be collected for three ci
nsecutive days
• Send the labelled sontainer ti the lab as early as pos
sible
Collection of blood
Collection of capillary blood by skin puncture:

• Hb concentration
• Counts of erythrocyte, leucocyte
• Bleeding time
• Blood grouping and typing, reticulocyte count perip
hral smear studies for hemoperasities
• In adult it is done in fingertip or ear lobe and in infa
nt the site preferable great toe and heal. Before coll
ection the selected site are cleaned by spirit.
Collection of blood by vein
puncture:
• The venous blood is obtain generally for 1.complete hb
2. ESR, Hemotocrit, clotting time 3. Test for coagulation
• Usually the median cubital vein in arm is perfect. Other
vein of the dorsam of the hand femoral vein, cephalic v
ein can also be used
• After intracting the patient about the procedure vein is
identified, Blood is drawn in a dry srerile syringe with o
ut existing much pressure
• Then collected in containers labelled and send to lab fo
r test.
Anticoagulation:
• Antickagulation are substance that prevent clotting
of blood when mixed in appropriate amounts with t
he blood sample. They mostly act on calcium and c
onverts it to can unit arited from the blood clotting
is prevented. Heparin is another anticoagulent. Besi
de trisodium citrate double oxalate is used.
Red cell count:
• EDTA or double oxalate blood or capillary blood is c
ollected for RBC count. Normal value of RBC in mal
e is 4.5 to 6.0 million cells and female 4.0 to 5.0 mill
ion cell/mm3. RBC count decreased when anemia,
pregnancy and other causes occure somatime. The
value increased for polycythemia, cyaretic heart du
sorders.
White cell count :
• EDTA or double oxalated blood or capillary blood is
collected for WBC count. Normal value of WBC in a
dult 4000 -11000cells/mm3
Platelet count
• EDTA or double oxalated blood or capillory blood is
mostly preferred for platelet count. Normal value o
f platelet is 20000 -400000cells/mm3
General instruction
• No antiseptic or antimicrobial agents should come in
to contact with the specimen. All specimen containe
r should be sterile
• In collaction of specimen, care must be taken to avoi
d contamination of the outside of container because
it affects the laboratory staff
• Specimen should be transported to lab immediately
otherwise suitable transport medium has to be used
• Proper disposal of specimen after use must be ensur
ed.
Nail care:
• A hard transperant plate of keratin called waib grow
s from its root which is under a thin fold of skin call
ed cuticle
• Nails require special attention to prevent infection
dews and injury to the tissues
• Problems usualy result from poor care of nail auch
as bitting then trimming improperly.
Inspection of nails:
• They are inspected for chope, texture, flexibility an
d colour. Normal nails are usually convex, smooth a
nd firm with a nail bed angle of about 160 degrees t
he nails is sourround by cuticle.
Procedure:
A tray containing the following article

• Cloth 1
• Mackintosh with towel
• Hand towel
• Vaseline
• Small bowl with warm water
• Nail cutter
• Kidney tray
• New linen
• Gloves 1 pair
Steps of procedure:
• Wash hand with soap and water
• Arrange all the articles
• Place the pt on chair in sitting position(if possible)
• Fill the basin and bowl with warm water
• Place mackintesh lined with towel and bowl of wate
r in the help of the patient
• Place the basin on the paper lining on the floor ask
the patient to dip his finger inthe bowl of water and
his feet in the basin
• Remove the basin and the bowl and dry fingers thro
ughly
• Cut finger nail straight with a nail cutter and shape
the nails with fill
• Clean the area and keep dry
• Apply vasline after soaking and nail trimming
Conclusion:
• Ckeaning of nail protects nail from any infection or
and other disorder. Cut to nails straight.
• Don't use any blades or sharp instrument to cut nail
.