Chapter 10 Specimen Collection. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.2...

Chapter 10

Specimen Collection

Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED. 2

Guidelines for Specimen Collection

• Apply principles of standard precautions

• Avoid environmental contamination

• Place lid on the table– Inner side up

• Avoid touching inside of container


Guidelines for Specimen Collection

• Transport specimen in a plastic bag with biohazard label– Attach the requisition

• Do not put specimens in a refrigerator with food or medications


Enemies of Specimen Collection

• Three enemies of specimen collection:1. Time (transporting the specimen)

2. Temperature (avoid extremes)

3. Desiccation (drying; do not let the specimen dry out)


Culture and Sensitivity Testing

• Culture determines if a pathogen is present– If so, whether the growth is heavy or light

• Sensitivity shows which antibiotics will best eradicate the pathogen



• Cultures are always collected in sterile containers.

• It takes approximately 3 days to get results– Preliminary results available within 24 hours



• Use good technique– Prevents picking up normal body flora and

environmental contaminants



• Collect an adequate amount of specimen

• Identify the specimen source and specific body collection site

• Make sure specimen is properly labeled

• Package properly if a pneumatic tube is used to transport to lab


Swab Cultures

• Use a culturette

• After collecting the specimen– Squeeze bottom of outer plastic tube to break

the inner ampule of transport medium

• When collecting a swab for Group A Streptococcus– Swab must be Dacron


Swab Cultures

• Rotate swab so all surfaces contact the wound bed or other area

• If swabbing a wound, use a zigzag stroke


Wound Infection

• Colonization is multiplication of a microbe after it has invaded the wound

• If wound is colonized, the microbe has successfully reproduced

• Signs or symptoms of infection are absent


Wound Infection

• All Stage II, III, and IV pressure ulcers become colonized with bacteria

• A colonized wound will heal– Infected wound will not


Sputum Culture

• Sputum is a secretion from the mucous membranes lining the trachea and lungs– It is not saliva from the mouth

• Collect early in the morning– Instruct patient to rinse mouth with water

before collecting the specimen


Gastric Specimen

• Gastric analysis checks for acid in the stomach

• Nasogastric tube must be inserted– Patient must be fasting

• Multi-step procedure that is collected over several hours


Midstream Urine Specimen

• Midstream (clean-catch) urine specimen– Collected from the middle of the urinary

stream

• Cleanse perineum according to facility policy prior to collecting the specimen

• Collect in a sterile container


24-Hour Urine Collection

• Tests for hormones, electrolytes, and proteins in urine over a 24-hour period

• Collection period starts when the patient has an empty bladder


24-Hour Urine Collection

• Collection container is refrigerated or stored on ice

• If a specimen is accidentally discarded– Stop test and begin again


Renal Calculi

• Also called kidney stones– May develop anywhere in the urinary tract– May result from mineral salts collecting

around bacteria, blood clots, or other particles– Stones are tiny, but very painful


Renal Calculi

• Renal colic is flank pain caused by obstructed urine– Sharp and severe in the lower back– Radiates around the body into the groin and

testicles


Stool Specimen

• Hemoccult® or guaiac test done bedside– Determines presence of occult blood in the

stool

• Use a tongue blade – Collect two tablespoons of stool from bedpan


Stool Specimen

• Use a culturette to collect a rectal swab– Insert 1 ½ inches– Use normal saline to moisten the swab– Avoid lubricants


Blood Glucose

• Two-hour post prandial blood sugar– Collected 2 hours after a patient eats

• Fingerstick blood sugar (FSBS)– Checked by collecting capillary blood


Blood Glucose

• Blood glucose meters – Calibrated daily

• Nosocomial infection can be spread by a community blood glucose meter– Issuing an individual meter to each patient is

best


Glycated Hemoglobin

• Glycated hemoglobin (A1C) – Blood sugar average over a three-month

period

• Persons without diabetes– Normal A1C value is approximately 5.0%

• ADA – Goal of therapy should be less than 7%

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Chapter 10 Specimen Collection. Copyright © 2007 Thomson Delmar Learning. ALL RIGHTS RESERVED.2...

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