NON-BLOOD Can you site some

SPECIMENS examples?
OVERVIEW
Although blood is the specimen of choice for many routine test,
various other substances are also analyzed:
Urine Amniotic fluid Synovial fluid
Feces Gastric fluid Buccal Swab
Nasopharyngeal secretions Saliva Bone Marrow
Semen Serous fluid Breath Sample
Sputum Sweat Throat Swab
Hair Cerebrospinal fluid Tissue
URINE
URINE
It is the most frequently analyzed non-blood specimen
It is readily available, easy to collect, inexpensive to test
MDDD
Monitor wellness
Diagnose and treat UTI
Detect and monitor metabolic disease
Determine effectiveness or complications of therapy
TRUE OR FALSE?
Urine is an ultrafiltrate of plasma.
Answer: True

Urine which is produced by nephrons, is a sterile bodily fluid.

Answer: True na naman.

The presence of bacteria in urine is diagnostic for Urinary Tract

Infection.
Answer: False = White Blood Cells are necessary for the diagnosis
URINE
Accurate results depend on:
CCSST
Collection method
Container used
Specimen transport
Specimen handling
Timeliness of testing
URINE
In-patients: Specimen collection handled by nursing personnel

Out-patients: often the responsibility of the Phlebotomist

*the phlebotomist must explain the procedures without
embarrassing the patient
URINE COLLECTION
Requires standard precaution
Gloves should be worn at all times
Specimen container
Clean, dry, leak-proof containers made up of *clear
material, with a wide mouth and wide, flat bottom.
Disposable
Recommended capacity:
 50 ml
URINE COLLECTION
All specimen must be labeled properly
 Must be attached to the container and not the lid

Requisition forms must accompany the specimen

 Time the specimen is collected, and received should be
indicated
SPECIMEN REJECTION
Improperly labeled and collected specimens should be rejected by
the laboratory and request for an new specimen
SNSCQ
Specimens in unlabeled containers
Nonmatching labels and requisition
Specimen contaminated with feces or toilet paper
Containers with contaminated exteriors
QNS (Quantity not sufficient)
Specimens improperly transported
SPECIMEN INTEGRITY
After collection, specimens must be sent to the laboratory and
tested within 2 hours
Preserve the specimen by refrigeration or use an appropriate
chemical preservative
If not properly preserved, the following changes may occur.

Increased: PABAON
pH Odor
Bacteria Nitrite
SPECIMEN INTEGRITY
Decreased analytes: CGKBTW Modified:
Clarity Color: Darkens
Glucose
Ketones
Bilirubin and urobilirubin
WBC and RBC
Trichomonas
TRUE OR FALSE?
Delay of more than 2 hours in processing of urine can cause any glucose
present to increase in concentration.
Answer: False

Delay of more than 2 hours in processing of urine can cause the pH of the
sample to Lower.
Answer: False uli…
Bonus round:
Ang English ng mapanghi, which we use to describe the smell of urine is
_________.
Answer: Ammoniacal
STRIP TEST
Leukocyte
Nitrite
Urobilinogen
Protein
pH
Haemoglobin
Specific gravity
Ketones
Bilirubin
Glucose
VOIDING ABNOMALITY
Oliguria- onting urine
Polyuria- 2000ml/ 2L urine a day, diabetes insipidus
Anuria- inability of the kidney to produce urine

Glucose threshold- 160-180 mg/dL of glucose

URINE COLLECTION
METHODS
URINE COLLECTION
METHODS
Regular Voided Specimen
 Requires no special patient preparation and is collected by
having the patient void into a clean urine container

Midstream Specimen
 Performed to obtain specimen free from genital secretions,
pubic hair, bacteria surrounding the urinary opening.
 Patient voids initial urine to toilet
 Flow is interrupted
 Collect a sufficient amount of urine
 Last flow of urine voided to toilet
URINE COLLECTION
METHODS
Midstream Clean-Catch Specimen
 Collected in a sterile container
 Suitable for microbial analysis or GS/CS
 Ensure specimen is free from contaminating matter from the
external genitalia
 Proper procedure varies from males to females
MIDSTREAM CLEAN CATCH FOR MEN:
WOWBVDVCW
 Wash hand thoroughly
 Open container without touching the inside of the container
 Wash the end of the penis with a special wipe or soapy water
 Begin at the urethral opening, working away from it in a circular motion
 Void into toilet and interrupt flow of urine
 Do not let the penis come in to contact with the container
 Void the remaining urine in the toilet
 Close the lid, clean any urine spilled with antiseptic wipe
 Wash hands
MIDSTREAM CLEAN CATCH
FOR WOMEN:
 Wash hand thoroughly
 Open container without touching the inside of the container
 Stand in squatting position over the toilet
 Separate the folds of skin around the urinary opening
 Cleanse the area on either side and around the opening with special wipes, using
fresh wipes for each area, wiping from front to back
 While keeping the skin fold separated, void into the toilet for a few seconds
 Collect the urine without letting the external genitalia coming into contact with
the container
 Void the remaining urine in the toilet
 Close the lid, clean any urine spilled with antiseptic wipe
 Wash hands
URINE COLLECTION
METHODS
Catheterized specimens:
Collected from a sterile catheter inserted through
the urethra into the bladder
Collected when patient is having trouble voiding or
is already catheterized for other reasons:
BFB
 babies for GS/CS
 female patients to prevent vaginal contamination
 Bedridden patients when serial specimen collections are needed
URINE COLLECTION
METHODS
Suprapubic Aspiration
 Insert needle directly into the urinary bladder and aspirating
the urine directly from the bladder into a sterile syringe
 Requires administration of local anesthetic
 Performed by Physicians
 Used for microbial analysis or Cytology studies
 Sometimes used to obtain uncontaminated specimens from
Children
URINE COLLECTION
METHODS
Pediatric urine collection
Uses a plastic urine collection bag with
hypoallergenic skin adhesive
 Patients genital area is cleaned and dried before the bag is
taped to the skin
 Placed around the vagina or over the penis
 Diaper is placed over the collection bag
 Check every 15 mins until an adequate specimen is
obtained
TYPES OF URINE
SPECIMENS
TYPES OF URINE SPECIMENS
Random
 can be collected anytime
 Used primarily for routine urinalysis

First morning/8 hour specimen

 Aka: first voided/overnight/early morning specimen FOE
 Collected immediately upon awakening in the morning after
approximately 8 hours of sleep
 More concentrated than random specimen
TYPES OF URINE SPECIMENS
Timed

2 hour post prandial specimen:

Collected 2 hour after a meal and tested for glucose
Used to monitor insulin therapy
Results are compared with fasting specimens

24 hour specimen
Allow quantitative analysis of a urine analyte
Specimen is pooled over a 24 hour collecting period
TYPES OF URINE SPECIMENS
24 hour urine specimen:
 Void into toilet upon awakening
 note time and date on specimen label, place it on the container and
begin timing
 Collect all urine voided for the next 24 hours
 Refrigerate the specimen throughout the collection period if required
 If bowel movement is anticipated, collect the urine specimen before,
not after it
 Drink normal amount of fluid unless instructed by physician to do
otherwise
 Void one last time at the end of 24 hours
 Seal the container, place in portable cooler, transport to lab ASAP
TYPES OF URINE SPECIMENS
Double voided specimen
 Requires emptying the bladder and then waiting for 30 mins
before collecting the specimen
 Commonly used to test for glucose and ketones

 Sa notebook pa po!
PROGRESS:
Urine Amniotic fluid Synovial fluid
Feces Gastric fluid Buccal Swab
Nasopharyngeal secretions Saliva Bone Marrow
Semen Serous fluid Breath Sample
Sputum Sweat Throat Swab
Hair Cerebrospinal fluid Tissue