Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.

Chapter 30Chapter 30Collecting and Testing Collecting and Testing

SpecimensSpecimens

Slide 2Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.

Specimens (samples) are collected and tested to Specimens (samples) are collected and tested to prevent, detect, and treat disease.prevent, detect, and treat disease.

The doctor orders what specimen to collect and The doctor orders what specimen to collect and the test needed.the test needed.

All specimens sent to the laboratory require All specimens sent to the laboratory require requisition slips.requisition slips.

Slide 3Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.

URINE SPECIMENSURINE SPECIMENS The random urine specimenThe random urine specimen

• The random urine specimen is collected for a routine The random urine specimen is collected for a routine urinalysis.urinalysis.

• No special measures are needed.No special measures are needed.

The midstream specimen (clean-voided specimen The midstream specimen (clean-voided specimen or clean-catch specimen)or clean-catch specimen)• The perineal area is cleaned before collecting the The perineal area is cleaned before collecting the

specimen.specimen.

• Sterile gloves are needed.Sterile gloves are needed.

• A sterile specimen container is needed.A sterile specimen container is needed.

Slide 5Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.

The 24-hour urine specimenThe 24-hour urine specimen• All urine voided during a 24-hour period is collected.All urine voided during a 24-hour period is collected.

• Urine is chilled on ice or refrigerated during this time.Urine is chilled on ice or refrigerated during this time.

• A preservative is added to the collection container for A preservative is added to the collection container for some tests.some tests.

• The person voids to begin the test with an empty The person voids to begin the test with an empty bladder.bladder.

Discard this voiding.Discard this voiding.

• Save all voidings for the next 24 hours.Save all voidings for the next 24 hours.

Slide 6Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.

The double-voided specimen (fresh-fractional The double-voided specimen (fresh-fractional urine specimen)urine specimen)• The person voids twice.The person voids twice.

• The first time the bladder is emptied of “stale” urine.The first time the bladder is emptied of “stale” urine.

• In 30 minutes the person voids again. In 30 minutes the person voids again.

• Fresh-fractional urine specimens are used to test urine Fresh-fractional urine specimens are used to test urine for glucose and ketones.for glucose and ketones.

Slide 7Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.

Testing urineTesting urine• Urine pH measures if urine is acidic or alkaline.Urine pH measures if urine is acidic or alkaline.

Normal pH is 4.6 to 8.0.Normal pH is 4.6 to 8.0. A routine urine specimen is needed.A routine urine specimen is needed.

• Testing for glucose and ketonesTesting for glucose and ketones These tests are usually done 30 minutes before each These tests are usually done 30 minutes before each

meal and at bedtime.meal and at bedtime. The doctor uses the test to make drug and diet decisions.The doctor uses the test to make drug and diet decisions. Double-voided specimens are best for these tests.Double-voided specimens are best for these tests.

• Testing for bloodTesting for blood Sometimes blood is seen in the urine.Sometimes blood is seen in the urine. At other times it is unseen (occult).At other times it is unseen (occult). A routine urine specimen is needed.A routine urine specimen is needed.

Slide 8Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.

Using reagent stripsUsing reagent strips• Dip the strip into urine.Dip the strip into urine.

• Compare the strip with the color chart on the bottle.Compare the strip with the color chart on the bottle.

• Follow the manufacturer’s instructions.Follow the manufacturer’s instructions.

Straining urineStraining urine• A stone (calculus) can develop in the kidney, ureter, or A stone (calculus) can develop in the kidney, ureter, or

bladder.bladder.

• Some stones are passed through urine.Some stones are passed through urine.

Slide 11Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.

STOOL SPECIMENSSTOOL SPECIMENS Stools are studied for:Stools are studied for:

• BloodBlood

• FatFat

• MicrobesMicrobes

• WormsWorms

• Other abnormal contentsOther abnormal contents

The stool specimen must not be contaminated The stool specimen must not be contaminated with urine.with urine.

Slide 14Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.

Testing stools for bloodTesting stools for blood• Often blood is seen if bleeding is low in the bowels.Often blood is seen if bleeding is low in the bowels.

• Stools are black and tarry (melena) if there is bleeding in Stools are black and tarry (melena) if there is bleeding in the stomach or upper GI tract.the stomach or upper GI tract.

• Sometimes bleeding occurs in very small amounts and Sometimes bleeding occurs in very small amounts and cannot be seen (occult blood).cannot be seen (occult blood).

• The test is often done to screen for colon cancer.The test is often done to screen for colon cancer.

Slide 16Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.

SPUTUM SPECIMENSSPUTUM SPECIMENS Sputum specimens are studied for blood, Sputum specimens are studied for blood,

microbes, and abnormal cells.microbes, and abnormal cells. The person coughs up sputum from the bronchi The person coughs up sputum from the bronchi

and trachea.and trachea.• It is easier to collect a specimen in the morning.It is easier to collect a specimen in the morning.

Older persons may lack the strength to cough up Older persons may lack the strength to cough up sputum.sputum.• Coughing is easier after postural drainage.Coughing is easier after postural drainage.

• The nurse or respiratory therapist does postural The nurse or respiratory therapist does postural drainage.drainage.

Slide 18Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.

QUALITY OF LIFEQUALITY OF LIFE Promote comfort by explaining the procedure to Promote comfort by explaining the procedure to

the person.the person. Some people can collect their own urine and Some people can collect their own urine and

sputum specimens.sputum specimens.• Doing so promotes independence and helps reduce Doing so promotes independence and helps reduce

embarrassment.embarrassment.