Specimen Collection

Question 1

Intake & output records: what does amount o fluid indicate?

Answer 1

→ amount of fluid a patient consumes and eliminate over a certain period of time is an indicator of their nutritional e fluid balance
→ will normally be same/ balanced (I & O)

Question 2

What does it help with & how to do it

Answer 2

»Provides insight for decisions of increasing or decreasing fluids/foods.
→ to measure use i&o + calorie count

Question 3

Collecting specimen & samples: rules

Answer 3

→ label containers and lids with clients name und other data
→ always Wash hands before & after
→ always wear gloves, eye protection, masks
→ clean area involved
→ sterile technique for sample collection
→ place all specimen in biohazard bags
→ transport to lab immediately
→ record collection and forward to lab
→ check health record to see if immediate attention is needed

Question 4

Measuring fluid intake: what is it?

Answer 4

→ all fluids consumed through the gastrointestinal (gi) system (mouth/ tube feeding) & fluids taken as part of intravenous (IV) therapy or TPN (total parenteral nutrition

Question 5

How to record

Answer 5

→ count ice as 50% water ( eg 100 mL of ice is 50mL of water)
→ wound drainage on dressings is measured by weighing dressing after it is removed and comparing with dry weight of identical dressing
→ convert weight to milligrams and to millilitres
→ record output and identify if not urine

Question 6

Urine specific gravity: what, when & How

Answer 6

→ indicator of concentration of urine compared to pure water
→ measured during urinalysis
→ measured with urinometer / hydrometer

Question 7

Hydrometer /urinometer: how to interpret

Answer 7

Normal range: 1.01 (dilute) - 1.025 (high concentration)
→ extremely concentrated: > 1.025, may indicate dehydration or edema
Low specific gravity: diabetes or excessive use of diuretic medications

Question 8

Instructions

Answer 8

→ be aware that content and amount of urine specimen varies with time, food and fluid intake
→ label with waterproof label
→ wake client in morning to obtain routine specimen

Question 9

Single voided urine specimen

Answer 9

Often ordered
Tests done to determine efficiency of kidneys / examine urine for abnormalities

Question 10

Clean - catch / midstream urine specimen

Answer 10

Specimen obtained w minimal contamination from external sources w/out inserting sterile catheter

Question 11

24 hour urine specimen

Answer 11

Urine accumulation quantity gives more deteris bc it shows type of quality/waste being exerted by kidneys
Collected for 24 h

Question 12

24 h fractional urine specimen

Answer 12

Determines amounts & characteristics of urine during different periods of day

Question 13

When to collect FUS?

Answer 13

12 am-6am/ 6 am-12pm/ 12pm -6pm/ 6pm- 12am

Question 14

Instructions for FUS

Answer 14

→4 specimen bottles covers & tables
→ label bottles before using, indicating times
→ collect all urine from first fraction of day in bottle 1
→ begin each collection time W empty bladder
→ label container before giving to client
→ instruct client to clean urethra area
→ use prepackaged wipes
→ instruct to cleanse front-back, cleanse each side W separate area / wipe, saving last for genital area itself
→ instruct to void small amount into toilet and hold rest for sterile container, catching the midstream urine
→ void last of stream into toilet
→ send specimen to lab w/out delay (can lead to false-positive result )
→ wear gloves when handling specimen
→ store specimen in ice/ fridge

Question 15

Collecting specimen from indwelling catheter

Answer 15

→ catheterized specimen will only be obtained il person is unconscious or has retention catheter
→ it contaminated, will cause infection bc microorganisms travel up catheter into bladder
→ collecting bag must not be elevated above level of bladder bc urine will flow back into bladder w microorganisms

Question 16

One time catheterized urine specimen: why

Answer 16

→ usually not done unless a specific contraindication for midstream clean catch specimen, another procedure is done at, same time
→ may be used for clients where clean catch specimen cannot be obtained ( unconscious, confused )
→ maybe ordered to determine residual urine volume (bladder that remains after voiding )

Question 17

Residual urine: how to identify

Answer 17

→ client voids, nurse catheterizers immediately and amount of urine is documented
→ significant amount indicates bladder obstruction or deficient contractility in detrusor muscles (that push down)

Question 18

Stool specimen: what is it

Answer 18

Provides info about functioning of GI system + accessory organs
→ most common test is presence of occult blood stool ( bleeding GI tract)
→ tests for O+p ( ova and parasites) indicates intestinal parasites and eggs

Question 19

Hemoccult / hemtest brand methods: hows stools are tested for hidden blood

Answer 19

→ nurse puts smear of stool on testing card w special narrow stick and adds drop of reagent (testing solution)
→ after time interval, smear is compared w colour chart to determine presence
Of blood

Question 20

Sputum specimen: what’s it (lungs)

Answer 20

→ patients W respiratory disorders
→ determine presence of tubercle bacillus (tuberculosis)
→ collected in morning after patient wakes up for 3 days in a row

Question 21

How, when to take and why sterilize container

Answer 21

→ obtain specimen before they eat, use mouth wash or brush teeth
→ sterile container ensures organisms cultured from specimen will be contained in specimen and not be result of contaminate container
→ keep cover on container to avoid air contamination or spread of organisms

Question 22

How to loosen and liquefy secretions

Answer 22

→ consume fluid and breathe humidified air / aerosolized meds make it easier to expectorate cough secretions
→ document aerosolized meds

Question 23

Order to measure sputum: 2 ways

Answer 23

1. If enough sputum is collected in graduated container, read amount directly
2. Pour equal amount of H2O in identical container and measure H2O

Question 24

Also do this…

Answer 24

→ weigh specimen (subtract initial weight of container)
→ take specimen to lab immediately after collection
→ label container and notify lab about sputum specimen
→ document amount, colour, consistency