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Specimen Collection
Stool, Semen, Sputum, and Nasal Specimen Collection
| Question | Answer |
|---|---|
| Stool specimens are collected both for | screening and for diagnostic tests. |
| fecal occult blood test (FOBT) | most commonly used point-of-care test for stool |
| Stool specimens can be sent to a laboratory for analysis for detection of | bacterial infectious agents, such as Clostridium difficile, ova, or parasites, or for other diagnostic tests. |
| Stool specimen collection may differ based on the diagnostic tests ordered. | Some tests require partial or full samples of stool for analysis, but most only require a sample the size of a walnut. |
| Collecting Stool Specimen - for some tests, the patient might have to follow a | specific diet and fluid regimen -eliminate some raw vegetables, red meat, poultry, and fish |
| Collecting Stool Specimen - Patients should discontinue taking | anticoagulants and NSAIDs 7 days prior to testing and not collect during hemorrhoid flares or menstrual cycles |
| for an enema must be performed to obtain a stool specimen, use | normal saline or a tap water enema. Caution must be used with tap water enemas. The tap water enema should never be repeated because it can cause water toxicity if the body absorbs a high amount |
| enema - Ask the patient to _________ prior to providing a stool sample and to deposit the sample in a dry, clean container for the collection so it is not contaminated by water or _______ | Urinate ; urine |
| Place stool samples in the appropriate specimen collection containers with | a tongue blade and replace the lids securely. Some require placing a preservative fluid in the specimen container. The fluid acts like transport media in test tube specimens to keep parasites alive. |
| some laboratory tests require multiple | samples from multiple stools to confirm the results. |
| Some samples require i_______ analysis at the laboratory while others can be refrigerated and analyzed later | Immediate |
| Stool collection - For infants, | avoid urine contamination of the stool by applying a urine collection bag. Then collect the urine-free stool from the diaper. If stools are liquid, place a liner in the diaper to keep the sample in place for collection. |
| A FOBT or guaiac test is | a widely used screening tool for colorectal cancer. It is routinely recommended for asymptomatic patients over the age of 50 as a prerequisite to colonoscopy. |
| Studies indicate that home testing with | three different samples is more accurate than a one-time office FOBT after a digital rectal examination. |
| FOBT samples should come from | fresh stools that are not contaminated with water or urine. |
| Point of Care - Fecal Occult Blood Testing (FOBT) - Patient instruct | instruct the patient to collect stool samples and place them on the developing cards with a small wooden stick that comes with the sample kit. |
| Point of Care - Fecal Occult Blood Testing (FOBT) - There are typically two windows on | each card on which to place a smear of the sample. The cards are then developed with a special solution that will react to blood if present in the stool.Often, blood is difficult to identify in the stool, which is why it is called occult blood |
| Point of Care - Fecal Occult Blood Testing (FOBT) - If the origin of the bleeding is high | in the gastrointestinal (GI) tract, the stool may appear dark or tarry. If the bleeding is from a hemorrhoid somewhere low on the GI tract or from menstrual bleeding, the stool may have bright red streaks of blood and might not yield an accurate result. |
| Sometimes the stool appears completely normal but | still contains blood, which is why an FOBT is so helpful. |
| If a patient has a positive FOBT result, the provider will | probably order additional diagnostic tests to identify the location of the bleeding and to help develop a treatment plan. Standard FOBTs should be used only with stool samples. They are not accurate for identifying blood in gastric contents. |
| Laboratory analysis of stool samples is ordered when infection or parasitic contamination is suspected. | 1. Leukocytes can be detected in the stool 2. The causative bacteria can be identified |
| Clostridium difficile is a common | bacterium that causes diarrhea and can be identified by stool sample analysis. |
| the parasitic infection is suspected, a stool sample is sent for a test called | ova and parasites. |
| If you are unsure of the appropriate collection method, storage conditions, or transport, be sure to | call the laboratory to confirm the protocol for the test ordered. |
| A semen analysis is a | test to measure the number and quality of your sperm. The lab will also measure the amount of liquid (semen) produced with the sperm |
| Sperm quality is determined by looking at | the shape of the sperm, the number of sperm, and how well they move. |
| A provider may order a semen analysis if a patient is having issues with | fertility / fathering a child or as post-vasectomy (surgery) care to assess the efficacy of the procedure. |
| Sputum specimens are | collected to provide a wide variety of diagnostic information. |
| Sputum specimens can be difficult to obtain because | they are easily contaminated with saliva. |
| Sputum specimens are most accurate when collected in the | morning before the patient has anything to eat or drink. |
| Supplies needed for the collection of a sputum specimen. | A. Clean gloves. B. A small cup of water. C. Emesis basin. D. Sterile specimen container with lid. E. Facial tissues. F. Disinfectant wipes. G. Client identification labels. H. Laboratory requisition form. I. Small biohazard plastic bag. |
| Key steps to sputum specimen collection. | A. Client rinsing with a small cup of water. B. Client spitting into an emesis basin. C. Client taking deep breaths. D. Client forcefully coughed directly into the specimen container. E. Sputum sample container in biohazard plastic bag |
| Patients who can cough and breathe deeply can be coached to | produce a sputum specimen and expel it into a collection container. |
| If patients who cannot produce enough sputum for the sample | Use chest physiotherapy to mobilize the secretions |
| Sputum Collection - For most tests, the sample should contain | 1 to 2 teaspoons of sputum |
| Sputum Collection -If less invasive methods do not result in an adequate sample, as a last resort do | suctioning and trans-tracheal aspiration (by a physician) are the last resorts. (Note: Do not confuse sputum collection with throat or gum swabbing, which is done for different purposes.) |
| Label the sputum specimen and store it as directed until | it arrives in the laboratory for analysis. Document the method of collection, the patient’s tolerance, and any pertinent physical findings in the patient’s medical record. |
| Specimen Collection – Throat and Nasal | Collect throat specimens from the patient’s oropharynx or tonsillar region using a sterile swab |
| Throat and Nasal Specimen Collection | A proper collection should include rubbing the sterile swab over the tonsillar area on the right and moving across the right arch, the uvula, and then the left arch and tonsillar area. Use caution not to touch the gums, tongue, or teeth with the swab. |
| Collect gum specimens by | lightly scraping the inside of a patient’s cheek with a sterile swab. These methods of specimen collection are used both for point-of-care tests and for laboratory analysis. |
| The most commonly performed point-of-care tests for throat specimens are rapid | staphylococcus, streptococcus (rapid strep), and rapid mononucleosis (monospot). |
| The most commonly performed gum swabbing point-of-care test is | rapid human immunodeficiency virus (HIV) testing. |
| Because point-of-care tests are not as | Accurate as laboratory tests, confirmatory tests are recommended for positive findings. |
| Storage conditions, inadequate specimen collection, and some patient factors can lead to | false-positive and false-negative results |
| You’ll place specimens for laboratory analysis in sterile tubes, | label the tubes, and transport them to a laboratory for analysis. Be sure to document the specimen collection technique, the patient’s tolerance, and any pertinent data in the patient’s medical record. |
| Acid-fast bacilli (AFB) | testing requires a sterile container and is performed on three serial samples to detect tuberculosis. |
| Cytology testing | requires a special preservative and identifies which form of lung cancer a patient has (small cell, oat cell, or large cell). |
| Clinical Laboratory Testing | Used in conjunction with health history and physical examination to provide essential data for the diagnosis and management of a patient’s condition. |
| Fecal Occult blood test (FOBT) | A lab test used to check stool samples for hidden (occult) blood. |
| Fowler's position | The patient sits on the examination table with the head of the table raised to a 90-degree angle. |
| Human Chorionic Gonadotropin (hCG) test | Pregnancy test. |
| Nasopharyngeal Swab specimen | Used to detect pathogenic micro-organisms in the nose and throat. |
| Throat Culture | Performed using a throat swab to detect the presence of group A streptococcus bacteria, the most common cause of strep throat. |
Created by:
CATCCMA