MNA Mosby ’ s Long Term Care Assistant Chapter 33 Collecting and Testing Specimens

Specimens Collected and tested to prevent, detect and treat disease. Ordered by MD Universal Precautions

Urine Specimens Routine Urinalysis RT U/A 120 cc Clean container Refrigerate prn Standard precautions Report & record Hematuria – blood in urine Also called Random Urine

Urine Specimens Clean catch Midstream CCMS Sterile container Resident needs to clean Catch middle of stream Refrigerate prn Standard precautions Report & record

Urine Specimens Double Voided Fresh fractional Used to test S/A Ac and hs Clean container Ask to void twice Standard precautions Report & record

Urine Specimens 24 hour urine clean container Usually 6am Discard first specimen Collect with Speci-hat Place on Ice Standard precautions Report & record

Testing Urine Reagent strips Blood S/A pH - acid or alkaline Standard precautions Report & record

Testing Urine Standard precautions Dip the strip Follow instructions for time Compare and read Report & record

Testing Urine S/A Sugar and acetone Diabetics Sugar:Acetone:NegativeTrace 1+Small 2+ Moderate 3+Large 4+ Results might be: N/N 1+/N Tr/Sm Glucosuria – sugar in the urine

Straining Urine A stone or calculus Vary in size All stones sent to lab

Stool Specimens Usually checked for blood Guiacc or Occult Blood

Stool Specimens Can be checked for O&P - Ova and Parasites Must be sent warm Clean container About 2 tablespoons Tongue blade for transfer

Sputum Specimens Mucus from the respiratory system Not Saliva Easiest to collect first thing in the morning Need 1 to 2 tablespoons Hemoptysis- bloody sputum Oral care before collecting a sputum specimen involves rinsing with clear water

Measuring Blood Glucose Used for persons with Diabetes Results used to regulate medication Capillary blood obtained through skin puncture

Puncturing the Skin to Obtain Capillary Blood only small amount of blood needed aseptic technique

Puncturing the Skin to Obtain Capillary Blood Common sites: Fingers Heels Ear lobes Children and adults infants adults

Puncturing the Skin to Obtain Capillary Blood Common sites: Fingers Thumb and index finger not used Fingers used most frequently X X

Puncturing the Skin to Obtain Capillary Blood Avoid fingers with: Edema Calluses Scars Rashes Sores Cyanosis

Puncturing the Skin to Obtain Capillary Blood Equipment: Gloves Sterile lancet Autolet Alcohol swabs Sharps container

Measuring Blood Sugar Levels Glucometer: Uses a reagent strip to test blood glucose levels.

Measuring Blood Sugar Levels Glucometer: Many different types. Follow manufacturer ’ s directions

Measuring Blood Sugar Levels Glucometer: Calibrate for accuracy Clean as directed

Measuring Blood Sugar Levels Normal blood glucose levels:

Review What is glycosuria ? Sugar in the urine CCMS ? Clean Catch Mid Stream

Review Always use a sterile container for all specimen collections. True False

Review Fresh fractional urine specimen is also called a Double voided

Review Occult blood? Hidden blood When is the easiest time to collect a sputum specimen? First thing in the am

Review Container for RT U/A? clean Container for CCMS? sterile

Review Container for 24 hour urine? clean Container for double voided? clean

Review Container for urine specimen that will be tested for S/A? clean

Review The perineal area is cleaned before collecting a 24 hour urine. True or False

Review What is done with the first specimen colleted in a 24 hour urine? discarded

Review How often do we routinely test urine for S/A? 4 x Ac and HS

Review What type of blood test is often used for persons with Diabetes? Glucose, Finger stick using a Glucometer

Review Normal blood sugar levels?

Review S/A QS pc HS ac QID BID Sugar and acetone Every shift After meals bedtime Before meals 4X day 2X day

Questions??