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

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

3. 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

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

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

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

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

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

9. 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

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

11. Stool Specimens Usually checked for blood Guiacc or Occult Blood

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

13. 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

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

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

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

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

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

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

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

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

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

24. Measuring Blood Sugar Levels Normal blood glucose levels: 80 - 120

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

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

27. Review Fresh fractional urine specimen is also called a Double voided

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

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

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

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

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

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

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

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

36. Review Normal blood sugar levels? 80 -120

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

38. Questions??