Prepared by Mrs / Hamdia Mohammed. At the end of this lecture each student should be able to: 1....
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Transcript of Prepared by Mrs / Hamdia Mohammed. At the end of this lecture each student should be able to: 1....
Prepared by Mrs / Hamdia Mohammed
SPECIMEN COLLECTION
LEARNING OBJECTIVES:-At the end of this lecture each student should be
able to:1. Define purposes of a specimen
collection.
2. Explain the different type of specimen collection.
3. Identify the universal precautions.
LEARNING OBJECTIVES CONT :-
6. List necessary information included in laboratory request form.
7. Identify nursing responsibilities associated with specimen collection
PURPOSES OF LABORATORY TEST
Assist in the diagnosis of pathological
conditions.
Evaluate the client’s progress and to regulate
treatment.
Prevent or reduce the severity of disease.
STANDARD PRECAUTIONS (UNIVERSAL PRECAUTIONS): THESE ARE BASED ON THREE RULES:-
Rule 1:- Consider ALL patients potentially infectious.
Rule 2:- Assume ALL blood, body fluids and tissues are contaminated.
Rule 3:- Assume ALL used needles or other sharps are contaminated.
TYPE OF SPECIMENS
1- Urine
2- Blood
3- Stool
4- Sputum
5- Wound culture sample
TYPES OF URINE SPECIMEN
Random specimen.
Midstream specimen.
Sterile specimen.
24-Hour urine collection.
Supra pubic needle aspiration of the bladder.
1. RANDOM SPECIMEN (CLEAN VOIDED)
A random routine urine specimen can be
collected with a client voiding naturally.
Uses:-* Routine Urine analysis testing
* PH
* Glucose level
CLIENT’S INSTRUCTION
- The client’s void into a clean urine cup, urinal, or bedpan.
- Client’s drinks a glass of fluid before the procedure about 30 minute.
- A client should be voided before defecating .
DEVICES FOR COLLECTING AND MEASURING URINE
A - Bedpan, fracture pan and Urinal containers for male patient used to collect urine from non ambulatory patientsB - Specimen hat : container that is placed interiorly on the toilet, underneath the seat. Used to collect urine. Specimen cup container
- Placing bedpan against buttocks while patient is on his side.
- Patient raising self in bed for bed pan.
2. MIDSTREAM URINE SPECIMEN
to obtain a specimen relatively free of the
microorganisms growing in the lower
Urethra. UsesUrine culture
CLIENT’S INSTRUCTION
- Cleansing of the external genitalia.
- Allowing the initial portion to escape.
- The clients collects the specimen during the middle portion of voiding .
- Remove specimen container before flow of urine stops and the client finishes voiding into bedpan or toilet .
3. STERILE SPECIMEN
Obtaining urine specimen from an indwelling catheter.
Uses - Urine culture.- Specific gravity: (urine
concentration or the amount of solutes metabolic wastes and electrolytes) present in urine .
OBTAINING A URINE SPECIMEN FROM A PATIENT
WITH AN INDWELLING CATHETER. (A) First, use a swab
moistened with an antiseptic to clean the area where the sterile needle will be introduced.
(B) Then insert the needle and withdraw a specimen of urine.
NURSE GUIDELINES
Washes hands and wear gloves.
Uses a sterile syringe to withdraw urine.
Urine specimen is not collected for culture from a urine drainage bag.
4. 24-HOUR URINE COLLECTIONS
Purpose - To assess the ability of the
kidney to concentrate and dilute urine.
- To determine disorders of glucose metabolism.
5. SUPRAPUBIC ASPIRATION
Indication : Patient with UTI. In neonate. Young infants. Patient whom catheterization is contraindicated. Suspected anaerobic bacteriuria .
GUIDELINES
The client’s should have a full bladder. Properly disinfected of the skin. 19 or 20 gauge needle is passed
through the skin into the bladder . Urine is aspirated into a syringe
BLOOD COLLECTION Wash hands Confirm the identity of the patient Explain the procedure Assemble all necessary equipment Put the patient in comfort position
BLOOD COLLECTION CONT.
Check both arms to select the larger and fuller veins.
Apply the tourniquet. Ask the patient to open and close
his/her fist so their veins become prominent.
Clean the venipuncture site with the alcohol swab in a circular motion.
BLOOD COLLECTION CONT.
Insert the stopper of the first tube to be drawn into the adaptor.
Insert the needle into the vein with the bevel facing upward.
Fill the tube until the vacuum is exhausted.
Place a cotton ball or 4 x 4 square piece of gauze over the site.
BLOOD COLLECTION CONT.
Remove gloves and dispose of in a properly identified biohazard bag or container.
Wash hands thoroughly after phlebotomy .
verify that the information on the sample tubes match is the requisition form
BLOOD CULTURE
Used to detect bacteria or fungi in the systemic circulation.
Performed by sampling peripheral blood using a no-touch or aseptic venipuncture method.
At least 10ml blood should be withdrawn and dispensed into two blood culture bottles, one for aerobic and one for anaerobic culture.
STOOL SPECIMENS
Purpose: 1- To determine the presence of
occulted blood for presence of (ulcers, inflammatory disease or tumors).
2- To analyze for dietary products. 3- To detect the presence of ova and
parasites. 4- To detect the presence of bacteria
or viruses.
PATIENT GUIDELINES FOR STOOL COLLECTION
Defecate in a clean container .
Do not contaminate the specimen
with urine or menstrual discharge.
Void first so urine is not in stool
sample.
Do not place toilet tissue in the
bedpan or specimen container.
Notify the nurse as soon as
possible after defecation and when
specimen is available.
SPUTUM SPECIMEN
# Sputum : Is the mucous secretion from the lung
bronchi, and trachea
# Saliva: the clear liquid secreted by the salivary
glands in the mouth
PURPOSE OF SPUTUM SPECIMENS
For culture
For cytology (to identify structure and pathology of cells such as to identify cancer in the lung
For acid fast bacillus to identify the presence of TB
TIME FOR COLLECTED
- In the morning.
- During postural drainage.
- Use pharyngeal suctioning when a
client
can not cough .
THROAT CULTURE
Sample collected from the mucosa of the oropharynx and tonsillar regions using culture swab
- Puts clean gloves.
- Inserts the swab into oropharynx and runs swab along the tonsils and are on the pharynx that are red or contain exudates.
WHO/CDS/EPR/ARO/2006.1
NASOPHARYNGEAL SWAB
Tilt head backwardsInsert flexible fine-shafted polyester swab into nostril and back to nasopharynxLeave in place a few secondsWithdraw slowly; rotating motion
WHO/CDS/EPR/ARO/2006.1
WOUND CULTURE SAMPLE
1- An aerobic specimen (Superficial Wounds )
2- Anaerobic specimen (Deep
Wounds: or abscess culture )
A. TO COLLECT AN AEROBIC SPECIMEN
Lightly palpate wound edges to detect localized areas of drainage collection
Clean a wound with normal saline to remove skin flora.
Use sterile swab from a culturette tube
TO COLLECT AN AEROBIC SPECIMEN CONT.
If wound edges are separated the nurse gently inserts the tip of the swab into the wound to collect deeper secretions .
TO COLLECT AN AEROBIC SPECIMEN CONT.
After collecting the specimen the nurse returns the swab to the culturette tube, and caps the tube.
Sends the labeled specimen to the laboratory.
B. TO COLLECT ANAEROBIC
SPECIMEN Clean site by wiping with sterile saline
or 70% alcohol.
The nurse uses a sterile syringe tip to aspirate drainage from inner wound.
Afterward the nurse apply a sterile needle to the syringe.
Expels the air from syringe and needle
and place a cork over needle to prevent entrance of air.
LABORATORY REQUEST FORM SHOULD BE INCLUDED THE FOLLOWING INFORMATION:-
The client’s name. Hospital number. Age and gender . Exact nature and source of the specimen. Diagnosis. Date and time of specimen collection. Ordering physician (Test requested or
laboratory test desired). Antimicrobial therapy ( medication as
antibiotic ) .
NURSING RESPONSIBILITIES ASSOCIATED WITH SPECIMEN COLLECTION
Provide client comfort, privacy and safety
Explain the purpose of the specimen
collection
Explain the procedure
Use the correct procedure for obtaining
a specimen
Hand washing & Use aseptic technique.
NURSING RESPONSIBILITIES ASSOCIATED WITH SPECIMEN COLLECTION CONT.
Note relevant information on the
laboratory requisition.
Make sure that the specimen label is
found.
Transport the specimen to the
laboratory promptly.
Report abnormal laboratory finding to
health care provider.
THANK YOU