Chest x-rays provide information about the lungs and heart by showing their size, shape, location and any abnormalities. The x-ray is taken with the patient standing and holding their breath from both front and side views. Sputum samples are collected by coughing or suctioning material from the lungs and airways to identify organisms, abnormal cells or determine the cause of illness. Samples should be collected in the morning before antibiotics and sent promptly to the lab for analysis, such as smears to identify white blood cells or bacteria, or cultures to identify microorganisms and test drug sensitivities. Proper collection and handling of samples is important for accurate diagnosis.

1. DIAGNOSTIC
TEST

2. CHEST X-RAY
• Provides information regarding
the anatomic location and
appearance of the lungs
• To determine (abnormalities) size,
shape and location of the lungs
and heart
• Anteroposterior and left lateral
views are taken

3. BEFORE THE PROCEDURE
• Instruct the client to remove all jewelry and other metal objects
from the chest area.
• Assess the client’s ability to inhale and hold breath.( practice
deep breathing)
• Question female clients regarding pregnancy or the possibility of
pregnancy.

4. DURING THE PROCEDURE
• Pt stands on the floor and rest his chin on top of an X-ray cassette
holder instructed to take a deep breath and holds it for the
duration of the X-ray (few seconds)
• Left lateral view=arms over his head and his torso against the film
cassette.

5. AFTER THE PROCEDURE
• Assist the client to dress

6. SPUTUM EXAMINATION
• Specimen is obtained by expectoration or tracheal
suctioning to assist in the identification of organisms
or abnormal cells.
• Material coughed up from the lungs, contains mucus,
cellular debris, microorganism, and sometimes pus
and blood. The amount, color and constituents are
necessary in the diagnosis of many illnesses.

7. Sputum specimen
• Sample of material taken from the air passages for analysis
Sputum smear
• Shows presence of WBC and intracellular pathogenic bacteria and extracellular
bacteria
Sputum cytology
• Identify cytology (cancerous cell) changes, exfoliation, cytology
Sputum culture and sensitivity
• Identify presence of microorganism, drug sensitivity and selection of drug
treatment.

8. METHOD OF COLLECTION:
• Instruct client to rinse the mouth with plain water prior to
collection.
• Do not use mouthwash or antiseptic solutions.
• NO brushing NOR eating
• Always collect the specimen before starting antibiotics.
• Obtain 15 ml of sputum.
• If it is for C/S, send to laboratory immediately

9. • Obtain an early morning sterile specimen from expectoration.
-Deep breathing and coughing
-Deep breath exhale and cough up in short succession and expectorate into the
sterile container

10. If client can’t cough due to certain condition:
Sputum collection trap
• A plastic trap connected to suction catheter for analysis
• Tracheal suction (aspiration of secretion through the ETT/TT tube)

11. NOTE
• Evaluate if the specimen is taken from the GIT or Respiratory Tract
• Lungs = alkali
• Stomach = acidic
• Intestine = alkali

12. AFTER THE PROCEDURE
• Provide oral hygiene, label specimen correctly and send ASAP to
the LAB.

13. MYCOBACTERIUM TUBERCULOSIS