This document provides guidelines for assessing various vital signs including body temperature, pulse rate, respiration rate, and blood pressure. It discusses appropriate techniques for measuring each vital sign, normal ranges, factors that influence the measurements, and guidelines for documentation. The key vital signs covered are temperature (measured orally, rectally, axillary, or tympanically), pulse (measured at radial or apical sites), and respiration (assessed by chest or abdominal movement and counted for a full minute).

1. UNIT TWO
ESSENTIALASSESSMENT
COMPONENTS
General objective: At the end of this chapter, the learner will be
able to
•Measure patient body temperature
•Measure patient blood pressure
•Take patient pulse with acceptable technique
•Characterize patient respiration
•Collect body fluid specimen
•Collect blood specimen through vein, capillary and
artery puncture
1

2. Vital Signs (Cardinal Signs)
• Vital signs reflect the body’s physiologic status and
provide information critical to evaluating homeostatic
balance.
• The term ―vital is used because the information
gathered is the clearest indicator of overall health status
• Vital sign Includes:
• T (temperature),
• PR (Pulse Rate),
• RR(Respiratory Rate), and
• BP (Blood Pressure)
2

3. Times to Assess Vital Signs
• On admission –to obtain baseline data
• Whenever a change is suspected in the client’s status,
• According to a nursing or medical order
• Before and after the administration of certain
medications that could affect Respiratory and CVS
• Before and after surgery or an invasive diagnostic
procedures
• Before and after any nursing intervention that could
affect the vital signs. E.g. Ambulation
• According to hospital /other health institution policy.
3

4. Guidelines for measuring vital signs
• Vital signs are measured when the client is at rest
• Ensure equipment in working order and Select based on
the patient condition and characteristics
• Know the patient’s usual range of vital signs
• Know the patients medical history, therapies, and
prescribed medications
• Control or minimize environmental factors that affect
vital signs
4

5. Vital sign cont…
• The sequence for recording vital signs measurement
in the nurses’ notes is T-P-R and BP.
• Agencies usually have special graphic forms used to
record vital signs findings
5

6. 1.Body Temperature
• Body temperature is the measurement of heat inside
a person’s body (core temperature); it is the balance
between heat produced and heat lost.
• Maintained within fairly constant range by
thermoregulatory center in the hypothalamus.
• Heat is produced with in the body through
oxidation,
 Muscular activity (e.g. shivering),
basal metabolism …
6

7. Body Temperature cont…
• Heat is lost from the body through the:
• lungs (breathing),
• the skin (conduction, evaporation, convection,
and radiation ),
• body discharges (urine, vomitus, or blood) and
• feces.
7

8. Body Temperature cont…
There are Two Kinds of Body Temperature
1. Core Temperature
Is the Temperature of the deep tissues of the body,
such as the cranium, thorax, abdominal cavity, and
pelvic cavity
Remains relatively constant
Measured at tympanic, rectal site, and also by
invasive monitoring devices esophagus, pulmonary
artery and bladder
8

9. Body Temperature cont…
2. Surface Temperature:
– The temperature of the skin, the subcutaneous
tissue and fat
– It, by contrast, rises and falls in response to the
environment.
– Measured at Oral(sublingual) and axillary
9

10. Factors Affecting Body Temperature
1. Diurnal variations (circadian rhythms): Body
temperature is usually lowest in the morning and
highest in the late afternoon or evening.
2. Age
• Children’s temperature continue to be more labile than
those of adults until puberty
• Elderly people, particularly those > 75 are at risk of
hypothermia (temperature less than 35.5 oC).
10

11. Factors Affecting Body Temperature
cont’d
3. Exercise
• Hard or strenuous exercise can increase body temperature to as
high as 38.3 –40 oc –measured rectally
4. Hormones
• In women progesterone secretion at the time of ovulation raises
body temperature by about 0.3 –0.60C above basal temperature
11

12. Factors …cont’d
5. Stress
• Stimulation of skin can increases the production of
metabolic activity and heat production.
6. Environment
• Extremes in temperature can affect a person’s
temperature regulatory systems.
12

13. Alterations in body temperature
• Average normal body temperature is 370C or
98.6oF ,the range is 36-38 0C (96.8 –100 oF)
• Pyrexia- is a body temperature above the normal
range 380C - 410C( 100.40F – 105.80F)
• Hyper pyrexia- is a very high fever, such as >410C
• Greater than 420C leads to death
• Hypothermia- is a body temperature between 340C –
350C( 100.40F – 105.80F)
» Less than 340C leads to death
13

14. Common Types of Fevers
1. Intermittent fever: the body temperature alternates
at regular intervals between periods of fever and
periods of normal or subnormal temperature.
2. Remittent fever: a wide range of temperature
fluctuation (more than 2 0C ) occurs over the 24 hr
period, all of which are above normal
3. Relapsing fever: short febrile periods of a few days
are interspersed with periods of 1 or 2 days of
normal temperature.
4. Constant fever: the body temperature fluctuates
minimally but always remains above normal
14

15. Measuring Body Temperature
• Body temperature is measured in Celsius scale or
Fahrenheit scale.
• Degree Celsius can be changed in to Fahrenheit and
vise versa.
• 0C(9/5) + 32= 0F,
• 5/9 (0F–32)= 0C
• Sites to Measure Temperature
• Most common are:
• Oral, Rectal, Axillary& Tympanic
• Thermometer: is an instrument used to measure body
temperature
15

16. I. Measuring oral temperature
• Contraindication
• Child below 7 yrs
• If the patient is delirious, mentally ill
• Unconscious
• Uncooperative or in severe pain
• Surgery of the mouth
• Nasal obstruction
• If patient has nasal or gastric tubs in place
16

17. oral temperature cont…
• Equipment
• Thermometer: glass or electronic
• Two pairs of non sterile gloves
• Watch
• Dry Cotton
• Receiver/receptacle
• Soapy water
• tray
• Pen or pencil
• Vital following sheet or record form
17

18. oral temperature cont…
• Leave in place as specified by agency policy, usually
3–5 minutes.
• Precaution:
• Never use oral thermometer for rectal and vise
versa
18

19. II. Measuring rectal temperature
• Contraindications
• Rectal or perineal surgery
• Fecal impaction
• Rectal infection
• Neonates : since can cause rectal perforation and
ulceration
• Patient with diarrhea
• Disease of the rectum(anal fissure, hemorrhoid etc)
19

20. rectal temperature cont…
Equipment
• Thermometer: glass (client’s
bedside); electronic
• Lubricant (rectal, glass
thermometer) and disposable
protective sheath
• tray
• Two pairs of disposable gloves
• Pen or pencil
• Receiver /receptacle
• Vital following sheet or
record form
• Tissue paper
• Screen
20

21. rectal temperature cont…
• Place client in the Sims’ position with upper knee
flexed. Adjust sheet to expose only anal area.
• Insert thermometer or probe gently into anus: infant,
1.2 cm (0.5 in.); adult, 3.5 cm (1.5 in.)
• Measured as specified by agency policy, usually 3–5
minutes.
21

22. III. Tympanic temperature
• The tympanic temperature is placed snugly in to the
client’s outer ear canal
• It records temperature usually in 2 seconds
• Contraindication
• Perforated ear drum
• Ear infection(Otitis media)
• Any ear surgery
22

23. IV. Taking patient body temperature
(axillary)
Equipments
• Thermometer:glass or
electronic
• non sterile gloves
• Dry Cotton
• tray
• Face towel
• Receiver/receptacle
• Soapy water
• Watch with secondhand
• Pen or pencil
• Vital following sheet or record
form
23
The axillary method is safest and most noninvasive

24. Axillary To cont…
1. Explain the procedure to the patient
2. Wash hands
3. Assemble necessary equipment and bring to the
patient bed side
4. Make sure that the client’s axilla is dry, if it is
moist, pat it dry gently before inserting the
thermometer
5. After placing the bulb of the thermometer in to
the axilla, bring the client’s arm down against
the body as tightly as possible, with the forearm
resting across chest
24

25. Axillary To cont…
6. Leave glass thermometer in place as specified by agency policy
(usually 6–8 minutes). Leave an electronic thermometer in
place until signal is heard.
7. Remove and read the thermometer
8. Cleanse glass thermometer from fingers toward the bulb’s
9. Return used equipment and wash your hand
10. Record the readings
25

26. 2. PULSE RATE
• Pulse assessment is the measurement of a pressure
pulsation created when the heart contracts and
ejects blood into the aorta
• The PR is expressed in beats/ minute(BPM)
26

27. Factors Affecting Pulse Rates
• Age: as age increase the PR gradually decreases. New born
to 1 month –130 BPM :80-180 (range), Adult 80 BPM (beat
per minute) :60 –100 BPM (beat per minute)
• Sex: after puberty the average males PR is slightly lower
than female
• Exercise: PR increase with exercise
• Fever: increases PR in response to the lowered B/P that
results from peripheral vasodilatation –increased
metabolic rate 27

28. Factors…
• Medications: digitalis preparation decreases PR,
Epinephrine–increases PR
• Heat: increases PR secondary to vasodilatation
• Stress: increases the sympathetic nerve stimulation-
increases the rate and force of heart beat
• Position changes: decrease in the venous blood return
to heart decreases BP and increases heart rate
28

29. Variations in Pulse Rate by Age
Age Average PR Normal Range
New born to 1
Month
130 80-180
1 Year old 120 80-140
2 Year old 110 80-130
6 Year old 100 75-120
1o Year old 70 50-90
Adult 80 60-100 29

30. PULSE SITES
30

31. Assess Adult pulse for :
• Normal : 60-100 beats per minute (80 beats/minute) for
adult.
• Tachycardia: -excessively fast heart beat(greater than 100
beats/minute)
• Bradycardia:-slow heart bets per minute (less than 60
beats/minute)
• Weak, feeble or thready readily obliterated with pressure
from the finger tips
31

32. PULSE Cont…
• Pulse rhythm is the regularity of the heartbeat.
• It describes how evenly the heart is beating:
• Regular : the beats are evenly spaced
• Irregular : the beats are not evenly spaced
• Dysrhythmia (arrhythmia); is an irregular
rhythm caused by an early, late, or missed
heartbeat.
32

33. PULSE Cont…
• Pulse volume is a measurement of the strength
or amplitude of force exerted by the ejected
blood against the arterial wall with each
contraction.
• It is described as;
 Normal (full, easily palpable),
weak (thready and usually rapid),
strong (bounding).
33

34. Number Definition Description
0 Absent pulse No pulsation is felt despite
extreme pressure
+1 Thready pulse Pulsation is not easily felt
and slight pressure causes it
to disappear
+2 Weak pulse Stronger than a thready
pulse; light pressure causes it
to disappear
+3 Normal pulse Pulsation is easily felt, takes
moderate Pressure to cause
it disappear
+4 Bounding pulse The pulsation is strong and
does not disappear with
moderate pressure.
34

35. Procedure for measuring radial pulse
(the most common)
1.Wash hands
2.Explain the procedure to the client
3.Position the client’s fore arm comfortably with
the wrist extended and the palm down
4.Place the tips of your first, second, and third
fingers over the client’s radial artery on the
inside of the wrist on the thumb side.
5.Press gently against the client’s radial artery to
the point where pulsation can be felt distinctly
35

36. Procedure cont…
6.Using a watch, count the pulse beats for 30
seconds and multiply by two to get the rate per
minute
7.Count the pulse for full minute if it is abnormal in
any way or take an apical pulse
8. Return equipment and wash hand
9. Record reading and indicate site as “PR.”(pulse
rate)
36

37. 3. RESPIRATION
• Respiration –process of taking in oxygen and expelling
carbon dioxide from lungs and respiratory tract
• Ventilation(breathing) is another word, which refer to
the movement of air in and out of the lungs
• Hyperventilation: very deep, rapid respiration
• Hypoventilation: very shallow respiration
37

38. Respiration cont…
• Respiration occurs in two phases: internal and external.
• Internal respiration is the process by which oxygen is
taken from the bloodstream into the cell and carbon
dioxide is removed from the cell to the bloodstream.
• External respiration refers to delivery of oxygen to the
lungs so that it can be taken into the bloodstream.
38

39. Respiration cont…
• External respiration (breathing) has two
components:
• inspiration, the process of taking air into the lungs;
and
• expiration, expelling air from the lungs.
• It is the rate of external respiration that is measured
39

40. Two Types of Breathing
I. Costal (thoracic)
• Involves the external muscles and other accessory
muscles (sternoclodiomastoid)
• Observed by the movement of the chest up ward
and down ward.
• Commonly used for adults
II. Diaphragmatic (abdominal)
• Involves the contraction and relaxation of the
diaphragm, observed by the movement of abdomen.
• Commonly used for children.
40

41. Assess Respiration for:
• Rate: is described in breath per minute (BPM)
• birth to 6 weeks: 30–60 breaths per minute
• 6 months- 1yr : 25–50 breaths per minute
• 1yr- 3 years: 24–40 breaths per minute
• 6 years: 18–25 breaths per minute
• 10 years: 15–20 breaths per minute
• adults: 12–20 breaths per minute
41

42. Assess Respiration for con…
• measured for full minute, if regular for 30 seconds.
• Assessed by watching the movement of the chest or
abdomen.
• Rhythm: is the regularity of expiration and inspiration
• Depth: described as normal, deep or shallow. Normal
respiration has uniform depth.
• Deep: a large volume of air inhaled & exhaled, inflates most of the
lungs.
• Shallow: exchange of a small volume of air
• Effort: Normal breathing is automatic & effortless.
42

43. Characteristics of Normal
and Abnormal Breathing
• Eupnea-normal breathing rate and depth
• Bradypnea- is a respiratory rate of 10 or fewer breaths
per minute
• Tachypnea - is a respiratory rate greater than 24
breaths per minute for adults
• Apnea -temporary cessation of breathing
43

44. Characteristics cont…
• Orthopnea : is the term used if the patient can
breathe only when in an upright position
• Dyspnea : difficulty in breathing as observed by
labored or forced respirations through the use of
accessory muscles in the chest and neck to breath.
44

45. Factors Affecting Respiration Rate
Age
Activity level
Position
Drugs
Sex
Illness
Emotions
Temperature
45

46. Procedures to assess RR
1. Explain the procedure
2. Wash hands
3. Assemble the necessary equipment
–Watch with a second hand, Pen ,Pencil ,Vital sign
flow sheet or record form
4. Be sure the patient is comfortable position;
preferably, sitting or lying with head of bed elevated
45 to 60 degrees.
5. Before replacing client’s gown from auscultating
heart sounds, assess respirations.
46

47. Procedures Cont…
6.Place your hand over client’s wrist and observe one
complete respiratory cycle.
7. Start to count with first inspiration while looking at
second hand sweep of watch.
• Infants and children: count a full minute.
• Adults: count for 30 seconds and multiply by 2.
• If an irregular rate or rhythm is present, count
for a full minute.
47

48. Procedures Cont…
8. Observe depth of respirations by degree of chest wall
movement and rhythm of cycle (regular or
interrupted).
9. Comfort the client
10. Return equipment and wash hand
11. Record reading and
48

49. D. BLOOD PRESSURE
• Blood pressure is the force exerted by blood against
the wall of blood vessels.
• It includes arterial, venous and capillary pressures.
• Arterial blood pressure (BP) = cardiac output (CO) x
total peripheral resistance (TPR).
• Cardiac Output (CO) = Stroke Volume (SV)x Heart
Rate (HR)
49

50. BLOOD PRESSURE…
• Stroke Volume : amount of blood ejected out from
the heart per each contraction
• Cardiac out put, peripheral vascular resistance, blood
volume and blood viscosity are determinants of
Blood pressure.
50

51. Types of blood pressure
• Systolic pressure :is the pressure of the blood as a
result of contraction of the ventricle
• Ranges from 100 to 140mmHg
• Diastolic blood pressure : is the pressure when the
ventricles are at rest (relaxes) , normally ranges 60
to 90 mmHg
• Blood pressure is measured in mmHg and recorded
as fraction (i.e . systole/diastole).
51

52. blood pressure cont…
• Pulse pressure : is the difference between the
systolic and diastolic pressure . Average pulse
pressure is 40.
• An increase in blood pressure is called
hypertension(>140/90 mmHg); a decrease is called
hypotension(<90/60mmHg).
• Normal blood pressure is termed as normotension
52

53. blood pressure cont…
• Sites for Measuring Blood Pressure
– Upper arm : using brachial artery (commonest)
– Thigh : around popliteal artery
– Fore –arm : using radial artery
– Leg: using posterior tibial or dorsal pedis
53

54. Methods of Measuring Blood
Pressure
1. Direct blood pressure measurement (invasive
monitoring) involves
 placing a special tube in a vein and monitor central
venous pressure (CVP).
 Central venous pressure may be used to determine
fluid needs in shock, hemorrhage, or severe burns, to
detect pulmonary edema, and to determine the
extent of circulatory overload.
54

55. Types of sphygmomanometer
55
Aneroid
Mercury
Electronic
( automatic)

56. Factors affecting Blood Pressure
• Age
• Obesity
• Exercise
• Pain
• Emotional status
• Circulating Volume
• Disease state and medication
• Low hematocrit and external heat
56

57. 57

58. Procedure
1. Explain the procedure
2. Wash hands
3. Assemble the necessary equipment
4. Determine which extremity is most appropriate
for reading.
5. Have the client rest at least 5 minute before
measurement.
6. Use appropriate size cuff
7. Move clothing away from upper aspect of arm.
8. Position arm at heart level, extend elbow with
palm turned upward and for thigh, position with
knee slightly flexed. Use sitting or lying position 58

59. Procedure cont…
9. Make sure bladder cuff is fully deflated and pump valve
moves freely.
10. Locate brachial artery in the antecubital space.
11. Apply cuff comfortably and smoothly over upper arm,
2.5 cm (1 in.) above antecubital space with center of
cuff over brachial artery.
12. Connect bladder tubing to manometer tubing. If using
a portable mercury-filled manometer, position
vertically at eye level.
13. Palpate brachial artery ,turn valve clockwise to close
and compress bulb to inflate cuff to 30 mm Hg above
point where palpated pulse disappears, then slowly
release valve (deflating cuff), noting reading when
pulse is felt again .
59

60. Procedure cont…
14. Insert earpiece of stethoscope in ears with a forward
tilt, ensuring diaphragm hangs freely
15. Relocate brachial pulse with your non dominant
hand and place bell or diaphragm chest piece
directly over pulse. Chest piece should be in direct
contact with skin and not touch cuff
16. With dominant hand, turn valve clockwise to close.
Compress pump to inflate cuff until manometer
registers 30 mm Hg above diminished pulse point
identified in step 13.
17. Slowly turn valve counterclockwise so that mercury
falls at a rate of 2–3 mm Hg per second. Listen for
five phases of Korotkoff’s sounds while noting
manometer reading:
60

61. Procedure cont…
18. Deflate cuff rapidly and completely.
19. Remove cuff or wait 2 minutes before taking a
second reading.
20. Inform client of reading
21. Lower bed, raise side rails, place call light in easy
reach.
22. Put all equipment in proper place.
23. Comfort the client
24.Return equipment and wash hand
25. Record reading and interpret
61

62. Specimen Collection
• It is collection of samples for laboratory examination of
urine, stool, sputum, blood and wound drainage
Instructions and precautions
1. See that the specimen bottles/containers are clean.
2. Every specimen must have a label with the
 patient's full name, room no., ward no., and
hospital no. and nurse's signature, with date and
time.
3. Specimens must be placed at the specified place on the
laboratory specimen shelf.
62

63. Taking urine specimen
• is method of taking small portion of urine from
client, which can represent the client’s quality of
whole urine
Purposes
• diagnostic purposes
• Routine laboratory analysis and culture and
sensitivity tests
Indication
• End stage renal failure(acute)
• Drug toxicity
• Acute hemolytic problems
• Post operative evaluation
63

64. 1. Random collection (routine Urinalysis)/ a single
voided specimen
• Routine Urinalysis/screening in which urine is
collected at any time of the day
• Purpose
• To diagnose infections
• To monitor the disease process
• To evaluate the efficacy of treatment
 Note on the specimen label if the female client is
menstruating at that time
64

65. Random collection…
• Equipments
• Laboratory request form
• Clean container with lid or cover (1): wide-
mouthed container is recommended
• Bedpan or urinal (1): as required
• Disposable gloves (1): if available
• Toilet paper as required
 Pour about 10-20 mL of urine into the labeled specimen
bottle or container and cover the bottle or container
65

66. 2.Timed urine specimen collection
• is method of collecting urine specimen for
specified period.
• Some tests of renal function and urine
composition require urine to be collected over 2
to 72 hr.
• The 24 hour timed collection is most common
66

67. Timed urine cont…
• Purpose:
The test allow for the measurement of elements
such as amino acids, createnine, hormones, glucose
and adrenocorticosteroids, whose levels change
over time.
A timed urine collection can also provide a means
to measure the concentration or dilution of urine.
Used to monitor input and output
67

68. Timed urine cont…
• Equipment
• Large bottle or container
• Funnel if available and necessary
• format for recording
• Label for bottle
• Glove
68

69. 3.Mid stream (clean-voided) urine specimen
• It is method of collecting part of urine stream by
avoiding first and last part of urine in receptor.
• Purpose
• To take the specimen for culture and sensitivity
• To identify possible microorganism in the urine
• To detect and measure the presence of
abnormalities in the urine like RBC,WBC,PH and
albumin 69

70. Mid stream cont…
• Equipment
a. Commercial kit for clean –
voided urine containing:
– Sterile cotton balls
and/or 2X2 inch gauze
pads.
– Antiseptic solution
– Sterile water or saline
– Sterile specimen
collection container and
sterile glove
b. Soap, water, washcloth
and towel Bedpan(for non
ambulatory
client),specimen hat(if all
urine needs to be
measured),potty-chair (for
young child )
c. Completed specimen
identification label
d. Completed laboratory
requisition form
70

71. Procedures of Mid stream Urine
collection
1. Explain the procedure
2. Wash hands
3. Assemble the necessary equipment
4. Provide privacy for client around the bed or closing
room door. Allow mobile client to collect specimen in
bathroom or toilet
5. Give client cleansing towel, washcloth, and soap to
cleanse perineum, or assist client with cleansing
perineum (if able)
6. Assist bedridden client on to bedpan
7. Using surgical asepsis, open sterile kit or prepare sterile
tray.
71

72. Procedures…
8. Wear sterile gloves
9. Pour antiseptic solution over cotton balls (unless kit
contains prepared gauze pads in antiseptic solution)
10. Open specimen container, and place cap with sterile
inside surface up, and do not touch inside of
container.
11. Perform urine collection by assisting or allowing
client to independently cleanses perineum and collect
specimen.
72

73. Procedures…
12. Clean using swab
13. Collect 30 to 60 ml of urine.
14. Remove specimen container before flow of urine
stops and before releasing labia or penis. Client
finishes voiding into bedpan or toilet
15. Replace cap securely on specimen container (touch
only outside)
16. Cleanse urine from external surface of container
1.
73

74. Procedures…
17. Comfort patient
18. Empty bedpan (if applicable), remove and discard gloves,
and perform hand hygiene
19. Label specimen and attach laboratory requisition
20. Take specimen to laboratory within 15 to 20 minutes.
21. Return equipment and wash hand
22. Proper documentation
74

75. 4. Catheterized urine specimen for female client
• it is a collection of urine specimen by
introducing catheter in the urethral of the
patient
• Purpose
• To collect sterile urine specimen
• To have a sample for a patient who has
difficulty of passing urine
75

76. Equipments
Sterile
• Kidney dish
• Galipot(2)
• Gauze
• Forceps four
• Four Towel
• Lubricant
• Two Catheter
• Syringe
• Distill Water
• Specimen bottle
• Two Gloves
76

77. Equipments cont…
Clean
• Waste receiver
• Rubber sheet
• Flash light
• Measuring jug
• Screen
• Disposable glove
• Antiseptic Solution
• Two small basin
• Soap
• Wash cloth(2)
77

78. 2.Taking blood specimen
i. Vein puncture
• it is the procedure of using a needle to withdraw
blood from a vein
• Used for diagnosis and for determining variation in
blood composition of any Site of taking venous blood
Ante cubital vein
Ulnar vein
78

79. ii. Capillary or peripheral blood specimen
• It is method of taking small drop of blood
from capillary by pricking the skin.
• Site for pricking
• Tip of the finger (ring finger of the left hand)
• Lobe of the ear
• Infants plantar surface of the heel and the
plantar surface of the big toe
79

80. Capillary…
• Purpose
• To detect hemo-parasite
• To detect blood cell abnormalities
80

81. Capillary…
Equipment
• Antiseptic swab
• Glove
• Tray
• Safety box
• Waste receiver
• Lancet
• pen and pencil
• capillary tube
• record chart
• Glass of slide
• dry cotton
• Syringe with needle
81

82. Procedures
1. Explain the procedure
2. Wash hands
3. Assemble the necessary equipment
4. Put on glove
5. Clean the site with antiseptic swab
6. Prick the site with lancet
7. Collect a drop of blood on the glass slide
82

83. Procedures cont…
8. Spread the drop of blood along slide(smearing)
9. Try to work quickly so not to allow clothing on the
slide
10. Give alcohol for client to apply pressure to the site
11. Return used equipment and wash hand
12. Proper documentation
83

84. Procedures cont…
• NB: While smearing doesn’t use sharp edge to
avoid scratching of slide
• Precaution
Use safety box
Blood should never be taken from IV line or
above an existing line
Use personal protective equipment
84

85. Taking sputum specimen
• It is method of collection of coughed sputum from
diagnostic purpose( to rule out respiratory pathology).
Three major types of sputum specimen’s are-
A. Cytology- cytology or cellular examination of
sputum may identify aberrant cells or cancer.
B. Culture and sensitivity – used to identify specific
microorganism and to determine antibiotics to which
they are most sensitive.
85

86. sputum specimen Cont…
C. Acid-fast bacilli (AFB)-used to support the
diagnosis of tuberculosis (TB)
Suctioning may be indicated to collect sputum
from the client who is unable to spontaneously
produce a sample for laboratory analysis.
Suctioning may provoke violent coughing, which
can induce constriction of pharyngeal, laryngeal
and bronchial muscles.
86

87. sputum specimen Cont…
Equipment
• Sterile specimen container with cover
• Clean disposable gloves
• Facial tissue
• Emesis basin (optional)
• Toothbrush (optional)
• Completed identification label
• Completed laboratory request
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88. SPUTUM SPECIMEN COLLECTION
• Sputum Collection includes:-
Spot-Morning-Spot
1.Sputum Collection at first contact
2.Morning Sputum Collection/Over night
3.Sputum Collection at 2nd Contact
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89. 89