BIO 136/186
Microbiology and Parasitology
                                 Second Semester 2022 
                                       Cluster 2
                                    Clinical Instructors
                                   Dr. Cyrille Y. Panimdim
                                  Ms. Jessica S. Simporios
                                   Dr. Deborah G. Gemao
                                  Mrs. Ana Lou B. Navaja
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                                        Topic Objectives
                          1. Define what specimen collection is.
                          2. Identify the different kinds of specimen for analysis.
                          3. Enumerate the fundamental requirement to protect
                             rights of patients in specimen collection and analysis.
                          4. Articulate appropriate method of handling specimen for
                             analysis.
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Unit IV. Collecting Specimen
Collecting Specimen
   Is one way of knowing about the patient's
   health status by identifying pathogens and
   analyzing urine, blood, sputum, feces, etc.
        Nurses often assume the responsibility
        of specimen collection, however it can
        be performed by a physician at patient’s
        bedside.
SPECIMEN COLLECTION
      - the collection of the specimen for the purposes of diagnosis,
treatment and recovery.
SPECIMEN - a small quantity of a substance or object which shows
the kind and quality of the whole (sample).
Fundamental requirements to protect the patient’s rights:
                     - the act of agreeing to allow something to
                     happen, or to do something, with a full
                     understanding of all the relevant facts,
                     including risks, and available alternatives.
                     - that full knowledge and understanding is the
                     necessary factor in whether an individual can
                     give informed consent.
The fundamental requirements to protect the patient’s rights:
                      •   The patient must understand what will
                          be done during a test, surgery, or any
                          medical procedure and must
                          understand the risks and implications
                          before he or she can legally consent
                          the test or procedure.
NURSING RESPONSIBILITIES
 Reinforce physician’s explanation of
  the procedure.
 Confirm that the patient understands
  and verify that a written consent is
  NOT necessary for individual test;
  informed consent may be adequate.
 Keep the patient adequately informed of
  procedural details that could cause
  discomfort.
 Assist the patient throughout the procedure
  and determine allergies to iodine.
 Prepare the patient for diagnostic exams.
 The nurse must be prepared to answer
  questions for which the patient may need
  clarification.
 The patient needs to know if:
        - Nothing can be taken by mouth (NPO) after midnight
        - Breakfast will be held until the exam is complete.
        - A special room or piece of equipment is required for
          the test.
        - Medication is needed before or during the test.
NOTE: All patients admitted to a health care facility have at least
one laboratory specimen collected during hospitalization.
GENERAL PREPARATION OF THE CLIENTS:
·    Explain the procedure to the patient. It helps to gain
the client’s trust and cooperation.
·     When preparing the client the nurse’s explanation
should be clear, straight forward and complete.
·      Be sure that the client has understood clearly and
correctly the information.
GENERAL PREPARATION OF THE CLIENTS:
·     In case of collection of urine, instruct the client to
wash the genitalia with soap and water and then rinse it in
water before collecting the specimen.
·     Instruct the client not to contaminate the outside of
the bottle.
·     Instructions to use gloves and other barriers as
necessary.
TYPES OF CONTAINERS USED FOR SPECIMEN COLLECTION
·     All specimens are collected in clean and dry containers.
·     Use containers with wide mouth.
·     Sterile containers are used for culture.
·      Wax lined disposable cups are used for sputum and
stool specimens.
·
TYPES OF CONTAINERS USED FOR SPECIMEN COLLECTION
·     Large containers are used for 24 hours urine specimens.
·     Sterile test tubes are used to collect fluids.
·     Clean slides are used to collect smears.
·      No antiseptic solution must be present in the specimen
bottle as they may hamper the growth of micro organism and
thus obscure the results.
• Laboratory Exam of
  specimen provides important
  information about body
  functioning and contributes
  to the assessment of health
  status.
• Guidelines for Specimen Collection
- Consider the patient’s need and
  ability to participate in specimen
  collection procedures.
- Recognize that specimen collection
  may provoke anxiety, embarrassment
  or discomfort.
- Provide support for patients who are
  fearful about the results of a
  specimen exam.
- Recognize that children require clear
  explanation of procedures and that they
  need the support of their parents or family
  member.
- Obtain specimen in accordance with the
  specific prerequisite conditions as required.
- Wear gloves when collecting specimens of
  blood or other body fluids.
- Most specimens are transported to the lab
  in a separate outer plastic bag.
- Deliver specimens to the laboratory within
  the recommended time or ensure that they
  are stored properly for later transport.
- Use aseptic technique in all collections to
  prevent contamination, which can cause
  inaccurate test results.
- Wash hands and other skin surfaces
  immediately and thoroughly.
- Collect specimens in appropriate
  containers, at the correct time and in the
  appropriate amount.
- Properly label all specimens with the
  patient’s identification; complete lab
  requisition form as necessary.
The four rules when collecting
specimens:
1. Right specimen
2. Right time
3. Right amount
4. Right container.
Data placed on the specimen
label:
1. Client’s name
2. Address
3. Type of specimen
4. Date
5. Time
           COLLECTION OF URINE SPECIMEN
Collecting Single Urine Specimen:
     - Single urine specimen means the amount of urine
voided at a time.
- Usually the morning specimens are collected.
- 100-120 ml of urine will be sufficient for the usual tests.
          COLLECTION OF URINE SPECIMEN
Collecting Single Urine Specimen:
- Clean the genital
- Let client pass urine into clean urinal or a clean kidney
  tray or directly in to specimen bottle
- Tell client not to spill the urine on the outside of the
  container.
• Midstream urine specimen
  - Urine is collected after voiding is initiated (midstream)
and before voiding is completed.
  - This is the cleanest part of the voided specimen.
• Several tests can be ordered on one sample of urine: pH,
  protein, glucose, ketones, blood and specific gravity.
COLLECTING 24 HOURS URINE SPECIMEN:
- 24 hours urine specimen means to collect all the urine voided in
  24 hours.
- The collection of urine begins at 6AM
- All the subsequent voiding should be measured and collected in
  the bottle and labelled.
- Continue to collect till morning.
- Ask the client to void at 6 -AM on the next day and add it to the
  previously collected.
 24 – Hour Urine Collection
https://www.youtube.com/watch?v=T4uQJ05S
Ie0
Methods in urine collection
1. Straight catheter method
   Inserting a straight catheter
   into the urinary bladder and
   remove urine.
2. Foley Bag catheter method
   Obtaining a specimen from the
   port of an indwelling catheter
   using sterile technique.
3. Urine collection of an able client
4. Residual Urine
    This is urine left in the bladder after voiding.
    The patient voids through the catheter performed
    within 10 minutes.
Residual urine is more than 50 ml of urine remaining in the
bladder.
Stool specimens are collected for a
variety of reasons.
• Determine the presence of
  infection, bleeding or
  hemorrhage.
• Observe the amount, color,
  consistency and presence of fats.
• Identify parasites, ova and
  bacteria.
Stools to be examined for
parasites must be taken to the
lab immediately while the
parasites are still alive.
Determining the presence of
occult – indication of blood in the
stool
(Guaiac Test) – test to determine
bloody stool
Bright red blood indicates the
blood is fresh and that the site is
in the lower GIT.
Black, tarry feces indicates the
presence of old blood and that the
site of bleeding is higher in the GIT
Occult indicates blood is present in
the stool but cannot be determined
unless examined
Sputum, secretions from the lungs
and contains mucus, cellular debris,
blood, pus and microorganisms.
Sputum must come from deep in the
bronchial tree and best collected
early morning because the patient
has not yet cleared of the
respiratory passages.
Many tests can be performed on sputum.
These are:
  * Culture, to note or detect the
presence of microbes.
   * Sensitivity, to determine the
effectiveness of antibiotics.
  * Cytology, to detect cellular debris
  * To determine acid-fast bacillus,
organism which is responsible for
tuberculosis.
An anaerobic bacteria culture is a
method used to grow anaerobes from a
clinical specimen.
- Obligate anaerobes are bacteria that
  can live only in the absence of
  oxygen.
- Obligate anaerobes are destroyed
  when exposed to the atmosphere for
  as briefly as 10 minutes.
Veins are a major source of blood for laboratory
testing, as well as routes for IV fluids or blood
replacement.
Blood test can yield information about
nutritional, hematological, metabolic, immune
and biochemical status.
Nurses are often responsible for collecting
blood specimens; however, many institutions
have trained technicians to draw blood.
Assess for any special conditions that must be met before
specimen collection, if patient is to be NPO
                    Venipuncture involves inserting a hollow-
                    bore needle into the lumen of a large vein
                    to obtain a specimen.
                            The nurse may use a needle and
                            syringe or a special vacuum tube
                            that allows the drawing of multiple
                            blood samples.
Possible risks of venipuncture:
 anticoagulant therapy
 low platelet count
 bleeding disorders
Possible risks of venipuncture:
 presence of shunt or fistula
 after breast or axillary
  surgery
Collection Method of Venipuncture: Vacutainer system
The basilic and cephalic veins in the antecubital space are the
most common venipuncture sites.
All for Listening