Transcript Acello Chapter10

Chapter 10
Specimen Collection
Guidelines for Specimen
Collection
• Apply principles of standard precautions
• Avoid environmental contamination
• Place lid on the table
– Inner side up
• Avoid touching inside of container
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Guidelines for Specimen Collection
• Transport specimen in a plastic bag with
biohazard label
– Attach the requisition
• Do not put specimens in a refrigerator with
food or medications
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Enemies of Specimen
Collection
• Three enemies of specimen collection:
1. Time (transporting the specimen)
2. Temperature (avoid extremes)
3. Desiccation (drying; do not let the
specimen dry out)
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Culture and Sensitivity Testing
• Culture determines if a pathogen is
present
– If so, whether the growth is heavy or light
• Sensitivity shows which antibiotics will
best eradicate the pathogen
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Culture and Sensitivity Testing
• Cultures are always collected in sterile
containers.
• It takes approximately 3 days to get results
– Preliminary results available within 24 hours
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Culture and Sensitivity Testing
• Use good technique
– Prevents picking up normal body flora and
environmental contaminants
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Culture and Sensitivity Testing
• Collect an adequate amount of specimen
• Identify the specimen source and specific
body collection site
• Make sure specimen is properly labeled
• Package properly if a pneumatic tube is
used to transport to lab
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Swab Cultures
• Use a culturette
• After collecting the specimen
– Squeeze bottom of outer plastic tube to break
the inner ampule of transport medium
• When collecting a swab for Group A
Streptococcus
– Swab must be Dacron
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Swab Cultures
• Rotate swab so all surfaces contact the
wound bed or other area
• If swabbing a wound, use a zigzag stroke
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Wound Infection
• Colonization is multiplication of a microbe
after it has invaded the wound
• If wound is colonized, the microbe has
successfully reproduced
• Signs or symptoms of infection are absent
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Wound Infection
• All Stage II, III, and IV pressure ulcers
become colonized with bacteria
• A colonized wound will heal
– Infected wound will not
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Sputum Culture
• Sputum is a secretion from the mucous
membranes lining the trachea and lungs
– It is not saliva from the mouth
• Collect early in the morning
– Instruct patient to rinse mouth with water
before collecting the specimen
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Gastric Specimen
• Gastric analysis checks for acid in the
stomach
• Nasogastric tube must be inserted
– Patient must be fasting
• Multi-step procedure that is collected over
several hours
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Midstream Urine Specimen
• Midstream (clean-catch) urine specimen
– Collected from the middle of the urinary
stream
• Cleanse perineum according to facility
policy prior to collecting the specimen
• Collect in a sterile container
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24-Hour Urine Collection
• Tests for hormones, electrolytes, and
proteins in urine over a 24-hour period
• Collection period starts when the patient
has an empty bladder
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24-Hour Urine Collection
• Collection container is refrigerated or
stored on ice
• If a specimen is accidentally discarded
– Stop test and begin again
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Renal Calculi
• Also called kidney stones
– May develop anywhere in the urinary tract
– May result from mineral salts collecting
around bacteria, blood clots, or other particles
– Stones are tiny, but very painful
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Renal Calculi
• Renal colic is flank pain caused by
obstructed urine
– Sharp and severe in the lower back
– Radiates around the body into the groin and
testicles
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Stool Specimen
• Hemoccult® or guaiac test done bedside
– Determines presence of occult blood in the
stool
• Use a tongue blade
– Collect two tablespoons of stool from bedpan
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Stool Specimen
• Use a culturette to collect a rectal swab
– Insert 1 ½ inches
– Use normal saline to moisten the swab
– Avoid lubricants
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Blood Glucose
• Two-hour post prandial blood sugar
– Collected 2 hours after a patient eats
• Fingerstick blood sugar (FSBS)
– Checked by collecting capillary blood
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Blood Glucose
• Blood glucose meters
– Calibrated daily
• Nosocomial infection can be spread by a
community blood glucose meter
– Issuing an individual meter to each patient is
best
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Glycated Hemoglobin
• Glycated hemoglobin (A1C)
– Blood sugar average over a three-month
period
• Persons without diabetes
– Normal A1C value is approximately 5.0%
• ADA
– Goal of therapy should be less than 7%
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