Chapter 13 Flashcards
Nonblood specimen labeling and handling
- Should be labeled with same patient information as blood specimens
- Labeling should include type and/or source of specimen– Type: Swab Source: Throat
- Label should be applied to container – NOT THE LID
- Familiarity with handling requirements is needed to protect integrity of specimen & ensure accurate test results
- All body substances are potentially infectious
- Standard precautions must be observed in handling them
urine
– Most frequently analyzed nonblood body fluid
– Readily available, easy to collect, & inexpensive to test
– Provides information about many of body’s major metabolic functions
– Can be used to monitor wellness
– Must be appropriately collected to provide accurate results
– Specimen collection instructions are the responsibility of the lab
common urine tests
– Routine urinalysis (UA)
– Culture & sensitivity
– Urine cytology studies
– Urine drug screening
– Urine glucose & ketone testing
– Urine pregnancy testing
– Other urine tests
types of urine specimens
– Random
– First morning/8-hour
– Fasting
– Timed
suprapubic aspirate collection
Specimen is collected by the physician by needle aspiration or in-dwelling catheter through the abdominal wall
urine collection on children that aren’t potty trained
collected by placing and adhesive bag over the genital region
amniotic fluid
– Clear fluid that fills membrane surrounding & cushioning fetus
– Collected after 15 weeks gestation
– Obtained by physician in transabdominal amniocentesis
– Needle is inserted into mother’s abdominal wall into uterus
– About 10 mL of fluid from amniotic sac is aspirated
– Analyzed to detect genetic disorders & problems in fetal development
– Must be collected in sterile container, protected from light, & delivered to lab ASAP
cerebrospinal fluid (CSF)
– Clear, colorless liquid that surrounds brain & spinal cord
– Specimens are obtained by physician via lumbar puncture
– Used to diagnose meningitis, tertiary syphilis, multiple sclerosis
– Most common tests are cell count with differential, culture, total protein, glucose
Gastric Fluid/Gastric Analysis
– Examines stomach contents for abnormal substances
– Measures gastric acid concentration to evaluate production
Basal gastric analysis (phlebotomist only assists)
- Tube is passed through mouth & throat (or nose & throat) into stomach after fasting
- Sample of gastric fluid is aspirated
- Sample is tested to determine acidity prior to stimulation
- Stimulant is administered by IV
- Several more samples are collected at timed intervals
Nasopharyngeal Secretions
– From nasal cavity & pharynx
– Cultured to detect presence of microorganisms
– Collected using sterile Dacron or cotton-tipped flexible wire swab
– Swab is inserted into nose & passed into nasopharynx
– It is rotated, removed, placed in sterile container, labeled, sent
saliva
– Fluid secreted by glands in mouth
– Used to monitor hormone levels & detect alcohol & drug abuse
– Can be collected quickly & easily in a noninvasive manner
semen
– Sperm-containing fluid discharged during male ejaculation
– Analyzed to assess fertility or effectiveness of sterilization
– Examined for forensic reasons in criminal sexual investigations
– Collected in sterile containers, kept warm, & protected from light
Serous Fluid
– Found between double-layered membranes enclosing pleural, pericardial, & peritoneal cavities
– Can be aspirated for testing purposes by physician
– Types of serous fluid
sputum
– Mucous or phlegm ejected from trachea, bronchi, & lungs
– Collected for diagnosis or monitoring of lower respiratory tractinfections (tuberculosis)
– First morning specimens are preferred (larger volume)
– Collect at least 1 hr after a meal to avoid gagging or vomiting
– Patient removes dentures & gargles w. water
– Patient takes 3 or 4 deep breaths & then coughs forcefully,expelling sputum into container
sweat
analyzed for chloride content in diagnosis of cystic fibrosis.
Used to detect illicit drug use, collected via skin patches
Sweat chloride test
- Pilocarpine (sweat-stimulating drug) is transported into skin by electrical stimulation (iontophoresis)
- Sweat is collected, weighed, & analyzed for chloride content
synovial fluid
– Clear, pale-yellow, viscous fluid that lubricates movable joints
– Normally occurs in small amounts
– Increases when inflammation is present
– Can be tested to identify or differentiate arthritis, gout, & other inflammatory conditions
Buccal (cheek) swabs
– Less invasive, painless alternative to blood collection for obtaining cells for DNA analysis
– Phlebotomist gently massages mouth on inside of cheek with swab
– DNA is extracted from cells on swab
bone marrow
– Aspirated & examined to detect & identify blood diseases
– Physician inserts large-gauge needle into bone marrow in hipbone or sternum
– 1.0 to 1.5 mL of specimen is aspirated using syringe
breath samples
C-urea breath test
Hydrogen breath test
Feces
– Useful in evaluation of gastrointestinal disorders
* Evaluated for presence of intestinal parasites & their eggs
* Checked for fat & urobilinogen content
* Cultured to detect presence of pathogenic bacteria & viruses
* Tested for presence of occult blood using guaiac test
hair
– Collected for trace & heavy metal analysis & detection of drugs
– Easy to obtain & cannot easily be altered or tampered with
– Shows evidence of chronic rather than recent drug use
throat swabs
– Collected to aid in diagnosis of strep infections
– Nurses collect from inpatients, phlebotomists from outpatients
– Collected w. sterile polyester-tipped swab in covered transport tube containing transport medium
Biopsy
removal of tissue sample for examination
Tissue specimens
– Most arrive at lab in formalin or other solution & only need to be accessioned & sent to proper department
– Phlebotomist should check procedure manual to determine proper handling for any unfamiliar specimen
– Improper handling can ruin a specimen
