Lecture 01 Specimen Collection & Venipuncture Flashcards
What are the steps to labeling the specimen, once it’s obtained?
- Signed with 1st initial, last name of person obtaining specimen.
- Dated and timed.
- 2nd person checks for accuracy of correct pt, matching label on specimen and that it matches re. 2nd person then initial requisition.
What are some factors that affects the accuracy of specimens for C&S (Culture & Sensitivity) ? (6)
- [*] Specimen contamination
- [*] Delay in sending specimen to laboratory
- [*] Obtaining specimen with inappropriate container or culture media
- [*] Incorrectly identified or mislabeled specimens
- [*] No identification of source of specimen
- [*] Not reporting any antibiotics or other medications that patient is taking that may impact specimen analysis.
Where can cultures be obtained using a sterile swab? (6)
- Throat
- Wound
- Body Cavity/Fluid
- Fistula
- Rectal
- Vaginal
What are reasons to obtain cultures from: wound/fistula?
Id of organism and potentially infectious agent of wound drainage. Determine appropriate treatments and interventions based on cuulture results.
What are reasons to obtain cultures from: sputum?
C&S for bacterial, viral, fungal infections and acid fast bacillus for mycobacterium tuberculosis.
What are reasons to obtain cultures from:Body cavity/fluid
Signs and symptoms of inflammation and infection
What are reasons to obtain cultures from:Stool?
Check for bacterial, fungal, parasitic infections, ova and parasites. C diff currently very prevalent.
What are reasons to obtain cultures from: Urine/urinalysis
- Presence of UTI
- Urinalysis also checks kidney and endocrine function, urine pH, color specific gravity, test for ketones, protein, gluclose, presence of red cell casts which may indicate infection or inflammatory conditions, presence of white cells may indicate infection
What are reasons to obtain cultures from: throat?
Presence of “strep” throat most commonly
Organism types obtained from: throat
Strep
Organism types obtained from: wound (4)
Staph, strep, pseudomonas, klebsiella
Organism types obtained from: Rectal (2)
Resistant enterococcus, C diff
Organism types obtained from: vaginal (2)
Various bacteria, chlamydia
Organism types obtained from: Nose & Skin (1 main one)
MRSA, Methicillin Resistant Staphylococcus Aureus
How is the throat culture obtained?
Have pt say “Ahh” and swab back of throat with sterile cotton swab from culterette packaging
Procedure for obtaining organisms from: wound culture
- Use sterile swab in drainage of wound or in the center of wound
- Do not swab outer edge or crusts near skin
- Can cleanse with NS (?)
- Redress per orders
How is a mid-stream collection done? Know this for Pt teaching
What is the purpose of it?
What are directions to pt? (9)
Purpose – to obtain as sterile urine specimen as possible without catheterization
Directions to a patient:
- [*] Wash hands
- [*] Open towelettes (3)
- [*] Open sterile container placing lid with inner side up. Do not touch rim of cup.
- [*] Cleanse each side of labia from front to back (women) or swiping motion away from meatus (men) – using separate towel for each side holding labia open
- [*] Cleanse down middle with 3rd (women) or from meatus out (men)
- Void a little urine into toilet
- Carefully hold cup and continue to urinate into the cup. Females should keep labia pulled apart as thy void.
- Place lid on urine without touching inside cup or lid
What are pt directions to Urine Collection? (4)
What is it used for?
- Usually begins first thing in the morning
- Pt should empty bladder, discard urine and note time
- Save all urine through and include the last void closest to the time that the collection ends 24 hours later
- If urine is discarded during collection, instruct the pt to get a new container and start again usually the next day. If in hospital with a new container, pt can use time discarded to begin an new colection.
Avoid ending the 24 hours in the middle of the night.
How is urinalysis usually done?
What does it check?
Done randomly without any prep
Used to check: urine dipstick values, kidney and endocrine function
[*] Urine pH, color
[*] Specific gravity
[*] Ketones
[*] Protein
[*] Glucose
[*] Presence of red cell casts which may indicate infection or inflammatory conditions
[*] Presence of white cells which may also indicate infection but does not identify an organism.
Not used for: culture and sensitivity
Why are stool specimens obtained?
For culture, fecal fat content, occult blood testing and presence of ova and paraistes
What’s the process of obtaining stool specimen for: culture?
Use sterile swab of stool or place stool in sterile specimen cup.
How often are you suppose to collect specimens for: fecal fat content?
Collect stool for 24, 48 or 72 hour period
What’s the process of obtaining stool specimen for:guaiac (occult blood testing)
What is this testing for?
Using wooden stick, place small amount of stool on each test site using stool from different locations.
Done to test for colon cancer and pt on anticoagulant therapy
Blood test also indicates a lot of things i.e colon cancer
What special procedures must be taken for oval and parasites culture?
The stool sample must be sent fresh and within 30 min. It can not be refrigerated.
What are some sites for venipuncture? (4) Most commonly used is which one?
Antecubital
what is the procedure to taking a venipuncture sample?
- ID patient, explain procedure to patient.
- Perform hand hygiene, don clean gloves.
- Apply tourniquet
- Select site
- Release tourniquet
- Cleanse site/allow to dry
- Reapply tourniquet
- Insert needle and obtain specimens
- Release tourniquet and remove needle covering site with pad
- Ensure labeling of specimens
- Remove gloves; perform hand hygiene
Learn Venipuncture from ATI & Craven
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