Chapter 34 Collecting and Testing Specimens Copyright 2017

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Chapter 34 Collecting and Testing Specimens Copyright © 2017, Elsevier, Inc. All rights reserved.

Chapter 34 Collecting and Testing Specimens Copyright © 2017, Elsevier, Inc. All rights reserved.

Specimens Ordered by doctors, specimens (samples) are collected and tested to prevent, detect, and

Specimens Ordered by doctors, specimens (samples) are collected and tested to prevent, detect, and treat disease. Most specimens are tested in the laboratory. Ø All specimens sent to the laboratory require requisition slips. Some tests are done at the bedside. Copyright © 2017, Elsevier, Inc. All rights reserved. 2

Urine Specimens Urine specimens are collected for urine tests. Random urine specimen is used

Urine Specimens Urine specimens are collected for urine tests. Random urine specimen is used for a routine urinalysis (UA). It is collected any time during a 24 -hour period. Ø Many people can collect the specimen themselves. • Weak and very ill persons need help. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 3

Urine Specimens (Cont. ) Midstream specimen (clean-voided specimen or clean-catch specimen) The perineal area

Urine Specimens (Cont. ) Midstream specimen (clean-voided specimen or clean-catch specimen) The perineal area is cleaned before collecting the specimen. Ø To collect the specimen: • The person starts to void into a device. • The person stops the urine stream. • A sterile specimen container is positioned. • The person voids into the container until the specimen Ø is obtained. Copyright © 2017, Elsevier, Inc. All rights reserved. 4

Urine Specimens (Cont. ) The 24 -hour urine specimen All urine voided during a

Urine Specimens (Cont. ) The 24 -hour urine specimen All urine voided during a 24 -hour period is collected. Ø Urine is chilled on ice or refrigerated during this time. Ø A preservative is added to the collection container for some tests. Ø The person voids to begin the test with an empty bladder. Ø • Discard this voiding. • Save all voidings for the next 24 hours. Ø The test is restarted if: • A voiding was not saved. • Toilet tissue was discarded into the specimen. • The specimen contains stool. Copyright © 2017, Elsevier, Inc. All rights reserved. 5

Urine Specimens (Cont. ) To collect a urine specimen from an infant or a

Urine Specimens (Cont. ) To collect a urine specimen from an infant or a child who is not toilet-trained, a collection bag (“wee bag”) is applied over the urethra. Voiding on request is hard for toilet-trained toddlers and young children. Potty chairs and specimen pans are useful. Ø Remember to use terms the child understands. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 6

Urine Specimens (Cont. ) The doctor orders the type and frequency of urine tests.

Urine Specimens (Cont. ) The doctor orders the type and frequency of urine tests. The nurse may ask you to do these simple urine tests. Testing for p. H • Urine p. H measures if urine is acidic or alkaline. • A random urine specimen is needed. Ø Testing for glucose and ketones • The diabetic person may have sugar (glucose) in the Ø urine and ketones in the urine. • Tests for glucose and ketones are usually done four times a day— 30 minutes before each meal and at bedtime. • The doctor uses the test to make drug and diet decisions. Copyright © 2017, Elsevier, Inc. All rights reserved. 7

Urine Specimens (Cont. ) Ø Testing for blood • Injury and disease can cause

Urine Specimens (Cont. ) Ø Testing for blood • Injury and disease can cause hematuria (blood in the urine). • Sometimes blood is seen in the urine. • At other times, it is unseen (occult). • A random urine specimen is needed. Ø Using reagent strips • Do not touch the test area on the strip. • Dip the strip into the urine. • Compare the strip with the color chart on the bottle. Copyright © 2017, Elsevier, Inc. All rights reserved. 8

Urine Specimens (Cont. ) Straining urine Ø A stone (calculus) can develop in the

Urine Specimens (Cont. ) Straining urine Ø A stone (calculus) can develop in the kidney, ureter, or bladder. • Stones (calculi) vary in size. • Stones causing severe pain and urinary system • damage may require removal by medical or surgical procedures. Some stones pass through urine. All of the person’s urine is strained. Passed stones are sent to the laboratory. Copyright © 2017, Elsevier, Inc. All rights reserved. 9

Stool Specimens Stools are studied for fat, microbes, worms, blood, and other abnormal contents.

Stool Specimens Stools are studied for fat, microbes, worms, blood, and other abnormal contents. Ø Bleeding may occur in very small amounts. • Stools are tested for occult (hidden) blood. • Stools are tested for occult blood to screen for colon cancer and other digestive disorders. • Occult blood test kits vary. Follow manufacturer’s instructions. Ø Urine must not contaminate the stool specimen. • The person uses one device for voiding and another for a BM. Ø Some tests require a warm stool. • The specimen is taken at once to the laboratory or storage area. Copyright © 2017, Elsevier, Inc. All rights reserved. 10

Sputum Specimens Mucus from the respiratory system is called sputum when expectorated (expelled) through

Sputum Specimens Mucus from the respiratory system is called sputum when expectorated (expelled) through the mouth. Ø Sputum is not saliva. Sputum specimens are studied for blood, microbes, and abnormal cells. The person coughs up sputum from the bronchi and trachea. Ø It is easier to collect a specimen in the morning. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 11

Blood Glucose Testing Blood glucose testing is used for persons with diabetes. Ø The

Blood Glucose Testing Blood glucose testing is used for persons with diabetes. Ø The doctor uses the results to regulate the person’s drugs and diet. Capillary blood is obtained through a skin puncture. A drop of blood is collected. Ø A fingertip is the most common site for skin punctures. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 12

Blood Glucose Testing (Cont. ) To perform a skin puncture: Inspect the puncture site

Blood Glucose Testing (Cont. ) To perform a skin puncture: Inspect the puncture site carefully for signs of trauma and skin breaks. Ø Do not use swollen, bruised, cyanotic, scarred, or calloused skin. Ø Use the side toward the tip of the middle or ring finger. Ø You use a sterile, disposable lancet to puncture the skin. • The person feels a brief, sharp pinch. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 13

Blood Glucose Testing (Cont. ) Using a reagent strip, a glucometer (glucose meter) measures

Blood Glucose Testing (Cont. ) Using a reagent strip, a glucometer (glucose meter) measures blood glucose. You apply a drop of blood to a reagent strip. Ø The blood glucose level appears on the screen. Ø Many types of glucometers are available. • You learn to use your agency’s device. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 14