Unit 15  Collecting Specimens

Specimens are the samples collected from patients such as a small amount of stood, blood, elimination (urine, stool), vomits, body secretions from the throat, vagina, penis, rectum, eyes, ears and wounds or lesion and body fluids from thoracic cavity or peritoneal cavity.

Chapter 1  Principles of Collecting Specimens

Principles of Collecting Specimens

●  Abide the doctor’s order. Whatever you do, you should abide the doctor’s order strictly.

●  Abundant preparation  The nurse should indicate the type, goal, amount, solution and the attention of collecting specimens before the procedure. The patient needs an explanation of the procedure and the procedure must be carried out with the consent of the patient.

●  Strictly check. Check the medication order, the patient’s bed card and diagnosis cawww.med126.comrefully before preforming the process.

Chapter 2  Sputum Specimens

Sputum is a mucous substance expelled by clearing the throat or by coughing. In the clinic, sputum specimen can be cataloged: routine sputum specimen, sputum specimen for culture, 24-hour collection of sputum.

Routine sputum specimen  To exam the sputum’s general appearance, cell or bacteria in the specimens, so as to aid the doctor in diagnosing problems in some respiratory diseases.

Sputum specimen for culture  To exam the disease-causing organism of sputum, and to identify the type of the bacteria and viruses.

24-hour collecting of sputum  To exam the amount and characteristics of sputum so as to help diagnose.

Routine Sputum Specimen

It is important for the nurse to observe the sputum when collecting it and to chart the observations accurately. The amount of sputum, the appearance (consistency and color), and the odor are significant.

●  Amount  The amount may be scant, moderate, or plentiful.

●  Appearance  Sputum containing pus may be yellow, gray or black. A rusty color or streaks of red blood may indicate pneumonia. An abscess in the lungs may create a green-colored sputum..

●  Odor  The odor may be described as sweet, putrid (foul).

Chapter 3  Blood Specimens

Classification of Blood Specimens

Blood specimen  To exam ESR, blood routine and to level of some substance, such as BUN, Cr, BN, BS, urine acid, creatine.

Serum specimen  To determine E₄A, enzyme, lipoprotein and lwww.med126.com/zhicheng/iver function.

Blood specimen for culture  To find out the disease-causing organism in the blood.

Collecting Blood Specimens

Blood by venipuncture is usually obtained from a vein on the inside surface of the forearm, near the elbow (antecubital space), where the veins are near the surface and easy to see or feel. Other areas where the veins stand out prominently may be chosen instead. If only a few drops are needed, the finger is picked with a lancet, and the blood is drawn up into a pipette, dropped onto a test strip, or smeared directly onto a glass slide.

Guidelines for Collecting Blood Specimens

●  Use a dry syringe, needle and tube to collect serum specimens.

●  Notice to anticoagulate, when collecting blood specimens.

●  After blood is pumped back into the tube, waggle the tube 8 to 10 times gently at once.

●  If CO₂CP is measured, blood should be inserted into the tube with paraffine and anticoagulant.

●  Avoid contaminating blood specimens for culture. Aseptic technique should be strictly implemented.

●  If three kinds of blood specimens should be prepared at one time, insert blood into the tube for culture first, then for blood specimen, last for serum specimen.

●  Forbid anybody to collect blood specimens from the needle through which fluid or blood is transfused.

●  Pump the plunger backwards, after collecting blood specimens successfully.

●  Syringes used should be immersed in the disinfectant first. You’d better use one-off syringe.

Chapter 4  Urine Specimens

Urinalysis is included in a health examination and is a part of the examination of every patient at the beginning and during an illness. In the hospital the laboratory staff does most of these examinations

Collecting a Routine Urine Specimen

A single voided specimen (clean-catch specimen) may be used to test for substances such as sugar, acetone, specific gravity, and albumin (protein), or for PH. Sometimes these tests are done to determine the efficiency of the kidneys. This is also called a single voided urine specimen.

A Urine Specimen for Culture

Midstream urine collection is the most common method of obtaining urine specimens for culture from adults, particularly men. By this method, a specimen not contaminated from external sources can be obtained without catheterization. If bacteria are found in the laboratory tests, they will truly be from the urine in the bladder.

Collecting 24-hour Urine Specimen

A 24-hour specimen of urine gives more detailed information than a single specimen because it shows what total amounts of wastes the kidneys are eliminating and the amount of each. The urine may be collected for 24 hours or for some part of that period, depending on the specific information desired. Antiseptics are generally used during the whole procedure. Common antiseptics include thick hydrochloric acid, toluene and formaldehyde.

Chapter 5  Fecal Specimens

Fecal specimen (a specimen of stool) is a sample of fecal material collected in a special container to be sent to the laboratory for examination.

Types of Fecal Specimens

Routine fecal specimen  This kind of stool specimen is collected to exam the characteristics and color of the stool, the cells in the stool. In general, you should collect a small amount of stool (about 5g) in the centre of the feces or mixed with pus and blood.

Collecting a fecal specimen for culture  Bacteria or viruses are both microorganisms which may be found in the stool. In order to be detected, they must grow and multiply in the stool. This requires the laboratory to prepare a culture of the stool.

Collection for occult blood  Occult blood is blood which is hidden in this case in the stool. Blood becomes dark after it passes through the body and is hard to detect. A patient who is bleeding inside often excretes blood through the stool. A specimen for occult blood need not be examined immediately or be kept warm. A meat-free diet may be ordered preceding this examination because meat residue may give a false report.

Collection for parasites  A parasite is an organism which lives on or within another organism. The parasite depends on the other organism and takes food and energy away from the other organism. Some worms, flukes and protozoa are parasites to the human. When stool is to be examined for parasites, it must be kept at body temperature and examined within 30 minutes.