Specimen collection and testing

1. SPECIMEN COLLECTION AND
TESTING
26/5/2020

2. COLLECTION OF SPECIMENS
A specimen may be defined as a small
quantity of a substance or object which
shows the kind and quality of the whole. It
is often a first step in determining
diagnosis and treatment.

3. COLLECTION OF SPECIMENS-
NURSE’S RESPONSIBILITY.
PREPARATION OF THE CLIENT:
• To put the client at ease , nurse must explain
the test with clarity and compassion, nurse’s
explanation should be clear , straightforward ,
and complete.
• Preparation include telling the client about the
purpose of the test , what to expect, how long
the procedure will take and how soon the
results will be available.

4. • Talk to the client throughout the test , to
comfort and encourage him/her.
• After the test is over, observe the client for any
untoward reactions or complications and be
prepared to implement appropriate care.
• On the previous day, explain the procedure to
the client .Explain what specimen to collect,
when to collect , how to collect and the amount
to be collected.
• Provide an appropriate container and
demonstrate to the client how to use it .
• Instruct the client not to contaminate the
outside of the bottle.

5. COLLECTION OF THE URINE
SPECIMENS PRINCIPLE:
1. Contaminated and improperly collected
specimens will produce false results which
will adversely affect in the diagnosis and
treatment of clients.
2. Specimens allowed to stand at the room
temperature for a long time will give a false
result due to :
a. Decomposition of specimen.
b. Multiplication of undesirable bacteria.
c. Destruction of pathogenic bacteria.

7. 3. Blood Chemistry is not uniform throughout the
day . It varies with the food intake.
( For the diabetic client, it is necessary to collect
urine specimen several times a day so as to
help the doctor to regulate the insulin
dosage.The urine Specimen are collected just
before the meal times).
4. The accuracy and reliability of findings depend
upon the correct method of collection ,
transportation of the specimens to the
laboratory and recording of reports. Inaccurate
results may mislead the physician in the
diagnosis and treatment of clients.

8. 5. Specimens serve as a media for transmission
of disease producing organisms to the
personnel who handle them carelessly.
INFORMED CONSENT:
• The physician may explain the procedure
purpose how it will be performed and its
potential risks.
• The nurses typically reinforces the physician’s
explanation , confirms the clients
comprehension, and verifies that written
consent has given whenever necessary.

9. • The client retains the legal right to withdraw the
written or oral consent at any time and for any
reason and to refuse care or treatment.
SAFETY MEASURES:
• Proper collection of specimens not only helps
to ensure accurate test results, but also
protects the client and the nurse.
• Nurse must see that they use gloves and other
barriers as necessary.

10. PREPARATION OF THE EQUIPMENT:
• All the specimens are to be collected in clear and dry
containers.
• Sterile containers are used to collect specimen for
culture.
• Waxlined disposable cups are used for the collection of
sputum and stool specimens.
• Large container are used to collect 24 hrs urine
specimen.
• Sterile test tube are used to collect fluids.
• Clean slides are used to collect smears.
• No antiseptic solution should be present in the
specimen bottles as they hamper the growth of micro
organisms and thus obscure the results.

11. • DOCUMENTATION:
Soon after the collection of the specimen the client
identification data , date and time, of collection
should be labelled and nurse should dully filled and
signed by the nurse who send the specimen for the
examination. It must be documented to the clients
record.

12. EXAMINATION OF THE URINE
Characteristic of the normal urine:
• VOLUME: An amount of 1000-2000ml of urine is
excreted in 24 hours. Urine output depends on the
water intake. In cold weather it increased and in hot
weather it is decreased.
• COLOUR: The colour is Pale yellowish or amber in
colour. When the quantity of urine is increased the
colour become pale yellow and when the quantity
of urine becomes decreased the colour is deep
yellow.

13. • Appearance: the normal urine is clear with no
deposits.
• Odour: The normal urine has an aromatic odour.
• Reaction: Reaction of the normal urine is slightly
acidic ( pH below 7).
• Specific gravity:It measures the concentration of
the urine solutes, which reflects the kidneys
capacity to conscentrate the urine. It varies from
1.016 to 1.025, with a normal fluid intake.

14. Characteristics of Abnormal urine
• Volume: Abnormal increase in the volume is
known as polyuria and is found in “diabetes
mellitus”and “diabetes insipidus.”
• Decreased quantity of urine is called “Oliguria”
found in heart disease and kidney disease.
• Total absence of urine is known as “ Anuria”.
• Failure of the kidney to secrete urine is known
as “ “Suppression”.

15. • Odour: Sweetish or fruity odour is due to the
presence of ketone bodies seen in diabetic clients.
• Appearance: Cloudy appearance is due to the
presence of amorphous phosphates.
• Reaction: When there is cystitis, the reaction of the
urine may be alkaline.
• Specific gravity: In disease the specific gravity
range from 1.001 to 1.060.It may be high due to
presence of sugar and it may be low in renal
disease.
• Constituents: Albumin is present when there is
kidney damage. Presence of albumin in the urine is
called Albuminuria.

16. STOOL SPECIMENS
Characteristics of normal stool:
Colour:
• Normally the colour of the stool is light to dark
brown due to the presence of bile pigments.
Odour :
• Normal stool has a pungent smell. It is normally
affected by the type of bacterial flora, by the food
and medications ingested.
Frequency :
One to two per day and it is painless.

17. • Consistency and form:
In adult , the stool is well formed and the consistency is
semisolid.
• Quantity:
Quantity depends upon the type and the amount of food
taken.
• Composition:
The faeces contain 30% water. The remaining portion
consists Shed epithelium from intestine, a considerable
quantity of bacteria, a small quantity of nitrogenous matter
mainly mucin,salts, calcium, phosphates, little iron and
cellulose if present in the diet.
• Stool of infants:
At birth the stool of infants is dark green and it is called
“ Meconium”. At the end of the 1st week it becomes yellow
and soft due to intake of milk diet.

18. Characteristics of Abnormal Stool:
• Colour: Tarry black stool indicate bleeding in the upper
Gastrointestinal tract. When the stool becomes black it
is known as “ Melaena”. Black stool may also result
from administration of iron or charcoal. Clay coloured
stools indicate obstruction to the flow of bile.
• Odour:Foul smell
• Frequency : Diarrhea
• Consistency and form : In constipation Flattened and
ribbon like stools which indicate obstruction in the
bowel. Watery stools found in diarrhea.
• Appearance: Fresh blood in stools suggests of bleeding
piles, mixing stool with menstrual blood, bleeding from
the large colon.

19. METHODS OF COLLECTING STOOL
SPECIMEN
aterproof disposable containers or widw
outhed containers are provided with
cessary instructions.
he client passes stool in a clean bedpan.
small amount of stool is removed with a
ck or spatula and is placed in the container.
scard the stick in the waste bin.