Specimen collection Role of the Nurse

Nurses often assume the responsibility of specimen collection Specimens consist Specimens consist Urine Urine Stool Stool Sputum Sputum Wound drainage Wound drainage Blood Blood

What about the client? Comfort Comfort Privacy Privacy Questions Questions Clear, concise directions Clear, concise directions NPO NPO

The Nurse Check physician orders Check physician orders Keep it Simple directions to client Keep it Simple directions to client Standard precautions Standard precautions Label specimen Label specimen Timely Timely C&S to lab ASAP or refrigerated C&S to lab ASAP or refrigerated Documentation Documentation

Urine Specimen Random Random Clean Clean Female ? Menses (make note) Female ? Menses (make note) Tested for: Tested for: Specific gravity Specific gravity pH pH Albumin Albumin Glucose Glucose Microscopic exam Microscopic exam

Urine for C&S Culture = ? Bacteria growing Culture = ? Bacteria growing Sensitivity = which antibiotics are effective Sensitivity = which antibiotics are effective Readings after 24; 48; 72 hrs. Readings after 24; 48; 72 hrs. Midstream Urine Sterile Catheter Specimen (never from bag)

Why a urine specimen for C&S ? Urinary Tract Infection (UTI) ? Urinary Tract Infection (UTI) Frequency Frequency Urgency Urgency Dysuria Dysuria Hematuria Hematuria Flank pain Flank pain Fever Fever Cloudy, malodorous urine Cloudy, malodorous urine

Obtaining specimen Wash hands Wash hands Clean meatus, female front to back Clean meatus, female front to back Start stream, then stop, collect specimen Start stream, then stop, collect specimen Aseptic technique Aseptic technique Bedpan/mexican hat Bedpan/mexican hat To lab 15-20min post collection To lab 15-20min post collection

Children Pediatric bags ( u Bag) Pediatric bags ( u Bag) Never squeeze diaper Never squeeze diaper

Characteristics of Urine Color Color Clarity Clarity Odor Odor

Specimen Collection 1. Random Specimens  Clean-not sterile  Ordered for  Urinalysis testing  Measurement of specific gravity  pH  Glucose levels

Urine specimen collection 2. Midstream Specimen  Clean voided  C&S  mls urine 3. Sterile Specimen  Indwelling catheter  Drainage bag

Urine collection 4. Timed urine specimens  2-72 hr intervals (24hr most common)  Begin after urinating  Note start time on container & requisition  Collect all urine in timed period Post Reminder Signs

Indwelling Catheter Strict aseptic technique Strict aseptic technique Only from Bag if Brand new Only from Bag if Brand new Sampling Port? Sampling Port? Clamp 30 min. prior Clamp 30 min. prior Wash hands – Glove Wash hands – Glove Cleanse port with alcohol swab Cleanse port with alcohol swab Sterile needle Sterile needle To lab 30 min (may refridge 2hrs) To lab 30 min (may refridge 2hrs)

Common Urine Lab Tests Routine Urinalysis Routine Urinalysis Examine within 2hrs Examine within 2hrs 1 st voided specimen in AM 1 st voided specimen in AM Reagent strip Reagent strip Specific Gravity Specific Gravity Concentration Concentration Urine glucose Urine glucose Diabetics Diabetics Reagent strips Reagent strips Double void Double void

Measuring chemical properties of urine=Urinalysis Glucose Glucose Ketones Ketones Protein Protein Blood- hematuria Blood- hematuria pH pH Specific gravity Specific gravity Microscopic examination Microscopic examination

Stool Specimen Analysis of fecal material can detect pathological conditions ie: tumors, hemorrhage, infection Tests Tests OB OB Pus Pus Ova & Parasites Ova & Parasites

URINE COLLECION

24 hours urine container URINE COLLECION

MEXICAN HAT

LEG BAG High quality plastic leg bags with lever action tap. Individually wrapped, sterile, with high quality leg straps. Available in a variety of sizes, 350ml, 500ml, 750ml, with long or short tube lengths

BED BAG BED BAGS UN2 - Economical non- drainable closed drainage bag: 2000ml capacity, non- return valve and a universal connector. Can also be hung from a bedside stand or frame. Supplied individually wrapped in cartons of 250

MID STREAM URINE COLLECTORS The laboratory analysis of urine specimens from hospital and home based patients represents an important part of 'first line' diagnosis for the patient. It is therefore important to gain the specimen effectively and easily.Universal offer a range of mid-stream urine collector kits to accomadate all catergories of patient. Available with Boric Acid to prolong the life of the sample

INTERMITTENT CATHETERS The Universal intermittent female catheter is a clear 20cm long medical grade PVC tube. Available in sizes 10fg - 14fg. The distal tip is rounded with two smooth polished staggered eyes and the proximal end has a funnel connector. Supplied individually wrapped and sterile

URINE DRAINAGE BAG HANGERS The Universal wire self-standing hanger can be adapted to fit most designs of 2000ml drainage bag. Stable yet lightweight design, supplied singly

Stool Specimen Analysis of fecal material can detect pathological conditions ie: tumors, hemorrhage, infection Tests Tests OB OB Pus Pus Ova & Parasites Ova & Parasites

Fecal specimens ? Chemical preservatives ? Chemical preservatives Medical aseptic technique Medical aseptic technique To lab on time To lab on time Labelling Labelling Documentation Documentation Guaiac Test Colorectal cancer screening test FOBT Hemoccult slide test

Fecal Characteristics Color Color melena melena Odor Odor Consistency Consistency Frequency Frequency Amount Amount Shape Shape Constituents Constituents

Guaiac Test Single positive test result does not confirm bleeding or colorectal cancer. Single positive test result does not confirm bleeding or colorectal cancer. Repeat test 3X Repeat test 3X Meat free, high residue diet Meat free, high residue diet