Specimens

Nurses often assume the responsibility

of specimen collection
 Specimens consist

 Urine  Vaginal

 Stool discharge

 Sputum  Throat swab

 Blood  Wound

drainage
 What about the client?

 Comfort

 Privacy

 Questions

 Clear, concise directions

 NPO
 The Nurse
 Check physician orders
 Keep it Simple directions to client
 Standard precautions
 Label specimen
 Timely
 C&S to lab or refrigerated
 Documentation
 Urine specimens
 What is urine?

 Liquid excretory by product of nitrogenous

metabolites

 Principally it is water(95%)

 Contains inorganic salts and organic

compounds(5%)

 Normal urine
Sample in test tube
Normal urine color

 Is a transparent solution
 Ranging from colorless to amber
color
 The color comes primarily from
the presence of urobilin
 Urobilin is waste product of heme
 Changes in Urine Color
 Colorless to pale yellow
 Dilute urine due to diuretics
 Alcohol consumption
 Diabetes insipidus
 Glucosuria

 Excess fluid intake

 Renal disease
 Yellow to milky white

 Pyuria, infection, vaginal cream

 Bright yellow

 Multiple vitamin preparations

 Pink to red

 Hgb breakdown,  Beets

 Red blood cells,  Blackberries
 Gross blood,  Medications
 Menses, (phenytoin,
rifampin)
 Bladder or prostate
surgery,
 Blue, blue green

 Dyes

 Methylene blue
 Pseudomonas species organisms,
 Medications (amitriptyline)
 Orange to amber
 Concentrated urine due to
 Dehydration

 Fever
 Bile

 Excess bilirubin or carotene,

 Medications (phenazopyridium
Hcl,calcium, thiamine)
 Brown to black
 Old red blood cells
 Urobilinogen
 Bilirubin
 Melanin
 ↑sed concentrated urine due to DHN
 Medications ( metronidazole, iron preparations,
quinine, methyldopa, nitrofurantoin)
 Methods
 Random specimen
 Clean-voided or midstream specimen
 Sterile specimen
 Timed urine specimen
 Urine Collection in Children
Contents
 Rules
 Wash hands before & after collection
 Standard Precautions
 Use correct & clean container
 Label
 Patient’s name
 Room & bed number
 Date & time specimen collected

 Collect specimen directly into container

 Don’t touch inside or lid
 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
 Cleaning methods
Females
Males
 Urine Specimens
 Clean catch midstream (cont.)

 Label on specimen
 Biohazard bag
 Requisition on outside of bag
 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 quantification

 Adrenocortical steroids
 Urine Specimens
 Timed Specimens (cont.)
 Begins: after client voids
 Discard sample and indicate starting time
on:
 Collection container
 Lab requisition slip
 Bathroom or bedside
 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
 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)
 Vaginal or Urethral Discharge Specimens
 Normally thin, nonpurulent, whitish or clear,
small in amount
 S&S STD’s, UTI
 Not Delegated
 Assess external genitalia
 If STD record sexual history
 Physician’s order- vaginal/urethral
 Fecal Specimens

 Hemacult or guaiac
 Ova and Parasites
 Culture and Sensitivity
 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
 Secretion of mucous from
 Lungs

 Bronchi

 Trachea

 Called sputum (not saliva)

 Expectorated from mouth or trachea
Reasons to study sputum

Sputum specimens (3 major types)

 C&S
 AFB
 3 consecutive, early am(SMS)

 Cytology
 Abnormal lung cancer by cell type
 3 early am
 Sputum collection
 Early a.m. best
 Allow to rinse with H20 NOT mouthwash
 Decreases food particles
 Decreases saliva

 Embarrassing & may be nauseating

 Container covered & in bag
 Privacy
 Standard Precautions
 Labeled

 Full name

 Room & bed number

 Time & date specimen collected

 SPUTUM --
 Observations
 Color
 Odor
 Consistency
 Blood

 Document
 Specimen obtained
 Where you took it