Unit 2 Lecture Flashcards
Characteristics of the collection containers
- Dry, disposable, leak-proof
- 4 cm opening
- Wide base
- Stand upright
Approximately, how much volume is needed for testing?
12 mL
What should be done if the sample cup is being brought home?
- Place in a biohazard bag to prevent spills during transport
- Return within 2 hours, REFRIGERATE if >2 hrs
What are patient “must-haves” that need to be on the label?
- Patient name
- Patient identification number
- Date and time of collection
- Patient location
What are some factors that would require you to reject a specimen?
- Improper labeling (unlabeled container or req and label do not match)
- Contaminated specimen (fecal or exterior)
- Insufficient quantity
- Wrong collection technique
- Improper transport
- Wrong Preservative
Which of the following is the best course of action if a urine specimen comes down to the laboratory without a label?
(a) Accept the specimen (b) Refuse to process the specimen without telling the nurse or provider (c) Request a new specimen (d) Get on the phone and scream at the nurse
(c) Request a new specimen
All of the following are requirements for a specimen container EXCEPT?
(a) wide base, stand upright, 4cm opening
(b) Free of chemicals and dirt
(c) Capacity of 50 - 100 mL
(d) Dirty cool whip container
(d) Dirty cool whip container
When providing the patient with instructions on proper specimen collection, directions should be in which of the following formats?
(a) The patient should just know how to collect a specimen
(b) Only verbal directions
(c) Only written directions
(d) Both verbal and written directions
(d) Both verbal and written directions
What are the three basic types of specimen?
(1) Random, (2) First morning, (3) Timed
What urine tests are used for random urine collection?
- Routine screening
- Cytologic studies
- Fluid deprivation testing
Advantages of random urine collection for testing?
Collection can be done at any time of the day.
Disadvantages of random urine collection for testing?
Increase fluid intake and excessive exercise may affect results.
What urine tests are used for first-morning urine collections?
- Routine screenings
- Confirm postural or orthostatic proteinuria
- Cytologic studies
Advantages of first-morning urine collection?
- Concentrated chemical components
- Preserved cellular components
Disadvantages of first-morning urine collection?
- Collection immediately on waking
- Amorphous sediment
What urine tests are used for time or short-term specimen?
- Quantitative chemical analysis
- Clearance test
- Cytology studies
- Evaluation of fistula
Advantages of time or short-term specimens?
None
Disadvantages of timed or short-termed specimens?
- Strict adherence to collection directions
- Collection requires two or more voided samples
- Requires collection over a period of time or a very specific time
Which of the following if the best specimen to collect to determine the quantity of a constituent?
(a) Random
(b) First morning
(c) Timed
(c) Timed
Which of the following is the most convenient for the patient to collect?
(a) Random
(b) First morning
(c) Timed
(a) Random
Uses of a routine void
Sports physicals and trichomonas
Initial part of void can be used for squamous epithelial cells
Patient preparation of a routine void
Requires no patient preparation
Precautions of a routine void
None
Uses of a mid-stream clean catch sample
Routine urinalysis, cultures, cytology
Patient preparation of a mid-stream clean catch sample
For males and females:
(a) Genital area clean with towelette; front to back (females), tip of penis (males)
(b) Repeat
(c) Begin voiding stopping midway through to collect sample than finishing.
What collection method best represents the urine that is in your bladder rather than urine in your urethra?
Mid-stream clean catch.
Precautions of mid-stream clean catch?
Do not touch the inside of the container.
Uses of catheterized specimen
Routine urinalysis, cultures, kidney infections
Patient preparations for catheter specimen
Catheter is inserted into the bladder via the urethra. Catheter inserted into the ureter.
Precautions for catheter speciemen
Collection is performed by a medical professional
Uses of subrapubic aspiration
Cultures
Patient preparations for subrapubic aspiration
Sterile technique is required. Needle is inserted directly into the bladder.
Precautions for subrapubic aspiration
Collection performed by medical professionals
This method requires sedation and can be expensive, therefore, it is rarely done unless the provider needs to minimize the risk of contamination.
Uses of pediatric collection bags
Routine urinalysis
Patient preparation for pediatric collection bags
Bag adheres to the skin
Precautions for pediatric collection bags
Care when placing bags; placing over anus might cause contamination.
Uses for 24-hour collection
Quantitative analysis, cytological studies, or clearance studies; helps to check for presence of albumin or creatine.
Patient preparation for 24-hour collection.
Written instructions for container.
Collection process: Day 1 –> 7am void discarded and collect until 7am on day 2. Day 2 –> 7am void and add to specimen.
Looking for the total volume of a constituent present.
Precautions for 24-hour collection.
Sources of error.
What is a Department of Transportation “DOT” Drug Screen and chain of custody?
Provides proof of correct collection and documentation and proves the sample was not altered. Collection was “witnessed” or “not witnessed”.
Temperature of specimen taken within 4 minutes and must be between 32.5 C and 37.5 C.
Which of the following is the best specimen for routine urinalysis and culture?
(a) First morning specimen
(b) Supra pubic
(c) Fasting specimen
(d) Midstream clean catch
(d) Midstream clean catch
A 24 hour was collected, what type of analysis is being performed?
(a) Quantitative analysis
(b) Qualitative analysis
(c) Routine analysis
(d) Timed analysis
(a) Quantitative analysis
What are the two main types of preservatives?
(1) Refrigeration; (2) Chemical
Common testing uses for refrigeration preservation.
Chemical and culture testing
Stability of urine specimen for refrigeration preservation.
24 hours.
What are some changes that can occur to the urine sample by choosing refrigeration preservation?
(1) Amorphous precipitation - dissolves back once return to room temp; (2) Temperature may effect chemical results.
Disadvantage of using Boric acid preservative.
Interferes with pH.
Disadvantage of using Hydrochloric acid preservative.
Destroys formed elements/bactericidal
Disadvantage of using Glacial acetic acid preservative.
Destroys formed elements/bactericidal
Disadvantage of using Sodium fluoride preservative.
Prevents glycolysis
Disadvantage of using Sodium carbonate preservative.
Preserves porphyrins and porphobilinogen
Disadvantage of using Formalin preservative.
Interferes with chemistry strip
Disadvantage of using Thymol preservative.
Interferes with protein test strip
What is Boric acid preservative used for?
Proteins/bacterial cultures
What is Hydrochloric acid preservative used for?
Calcium
What is Glacial acetic acid preservative used for?
Hormones/steroids
What is Sodium fluoride preservative used for?
Glucose
What is Sodium carbonate preservative used for?
Porphyrins and porphobilinogen
What is Formalin preservative used for?
Sediment
What is Thymol preservative used for?
Sediment
Change to color if urine is left unpreserved and left out.
Darken or changes; oxidation or reduction reaction (urobilinogen or bilirubin)
Change to clarity if urine is left unpreserved and left out.
Turns cloudy; crystals precipatate and bacteria proliferate
Change to odor if urine is left unpreserved and left out.
Ammonia/foul odor; bacteria converts urea to ammonia
Change to pH if urine is left unpreserved and left out.
pH increases; bacteria converts urea to ammonia: CO2 is lost
Change to glucose if urine is left unpreserved and left out.
Glucose decreases; used as energy for cells or bacteria
Change to ketones if urine is left unpreserved and left out.
Ketones decrease; volatile and bacteria conversion
Change to bilirubin if urine is left unpreserved and left out.
Bilirubin decrease; photo-oxidation to biliverdin by light exposure
Change to urobilinogen if urine is left unpreserved and left out.
Urobilinogen decreases; oxidation to urobilin
Change to nitrites if urine is left unpreserved and left out.
Nitrites increases; bacterial conversion of dietary nitrates
Change to blood cells if urine is left unpreserved and left out.
Blood cells decrease; lysis and/or disintegration in dilute and alkaline urine.
Change to casts if urine is left unpreserved and left out.
Cast decreases; disintegration, in dilute and alkaline urine
Change to bacteria if urine is left unpreserved and left out.
Bacteria increases; exponential proliferation of bacteria
Change to trichomonads if urine is left unpreserved and left out.
Trichomonads decrease; loss of motility and death.
Which of the following is the best preservative used for a urinalysis?
(a) Boric acid
(b) Sodium carbonate
(c) Acetic acid
(d) Refrigeration
(d) Refrigeration
What happens if ketones in a urine that has not properly been preserved?
(a) Decrease
(b) Increase
(a) Decrease
