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.
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 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 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 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 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. 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 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 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. 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 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 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 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. 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
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