10.1 Urine Specimen
A urinalysis is a valuable tool that allows for diagnosing and monitoring certain medical conditions. Urine testing examines the physical, chemical, and microscopic composition of a sample of urine including the color, turbidity, presence or absence of particles, odor, pH, specific gravity, protein, ketones, glucose, bilirubin, nitrites, and leukocytes. Common types of urine sample collections include clean-catch collection, twenty-four-hour urine collection, FMV collection, timed collection, catheter collection, suprapubic aspiration, pediatric bag collection, and random urine collection. The procedure for urine collection depends on the type of test ordered; however, regardless of the type of sampling, a sterile collection is essential for ensuring the sample is not contaminated. Following the collection procedure, it is important to label the specimen with the correct patient identifiers and transport the sample to the laboratory within a reasonable time frame. Other key aspects of collecting a urine sample include educating the patient on how to perform the procedure (particularly regarding measures for keeping the sample free of contamination) and accurately documenting the procedure. To correctly interpret the results, the nurse must be aware of normal findings, abnormal findings, and factors that affect the results. Urinalysis results may be affected by a variety of factors, including diet, medications, medical conditions, and contamination.
10.2 Stool Collection
Stool collections are a valuable tool for diagnosing and monitoring certain medical conditions. Stool testing examines the physical, chemical, and microscopic composition of a sample. It assesses factors such as color, consistency, shape, odor, mucous, undigested good particles, parasites or worms, blood, fats, carbohydrates, enzymes, and pH. Common types of stool sample collections include random collection, three-day collection, fecal occult blood, stool culture, O&P testing, stool fat testing, and C. difficile testing. Stool samples may be collected in a plastic container or on plastic wrap and then transferred into the collection cup with a wooden stick. Caution must be given to ensure the sample is not contaminated with urine, toilet paper, or other potential sources of bacteria. Occult blood testing collects samples from different parts of the stool and smears them on a sampling card to determine the presence of blood in the stool. Following either type of collection procedure, it is important to label the specimen with the correct patient identifiers and transport the sample to the laboratory within a reasonable time frame. Other key aspects of collecting a stool sample include educating the patient on how to perform the procedure (particularly regarding measures for keeping the same free of contamination) and accurately documenting the procedure. To correctly interpret the results, the nurse must be aware of normal findings, abnormal findings, and factors that affect the results. Stool collection results may be affected by a variety of factors, such as diet, medications, medical conditions, timing, and contamination.
10.3 Sputum Collection
Sputum, nasal, and throat specimens are key in diagnosing and managing various respiratory conditions, including bronchitis, pneumonia, COVID-19, influenza, tuberculosis, COPD, and lung cancer. Methods of sputum collection include spontaneous and induced collection, nasotracheal suction collection, bronchoscopy collection, and collection via a sputum trap. Methods of nasal and throat collection include nasopharyngeal, oropharyngeal, and nasal.
Key aspects of collecting a sputum, nasal, or oropharyngeal specimen include educating the patient on how the procedure is performed, performing the procedure correctly to obtain a quality specimen, and accurately documenting the procedure. To correctly interpret the results, the nurse must be aware of normal and abnormal findings as well as factors that affect the results. Factors such as diet, medical conditions, medications, underlying conditions, and proper collection techniques may affect the sputum results. Factors such as proper collection technique, time of testing in relation to onset of symptoms, swab selected for collection, and administration of antibiotics and antivirals may affect nasal and throat specimen results.
10.4 Blood Sampling
Understanding blood and its properties is crucial for healthcare professionals in diagnosing and managing various medical conditions. Blood is a complex bodily fluid with distinct chemical, physical, and microscopic characteristics. Blood is composed of plasma, red blood cells, white blood cells, and platelets. Chemical, physical, and microscopic characteristics of blood include pH, blood gas levels, color, viscosity, volume, temperature, and specific gravity as well as presence of red blood cells, white blood cells, platelets, and microorganisms.
Collecting a blood specimen is a fundamental aspect of patient care and medical diagnostics. Blood samples may be taken from veins, arteries, or capillaries. Whereas venous and arterial samples are collected by inserting a needle into the vein or artery, capillary samples are collected by puncturing the skin of the finger, heel, or earlobe with a lancet. Venous samples may also be collected using strict aseptic technique from an existing central line by trained professionals. Proper technique and equipment are essential to ensure the accuracy of the sample and the patient’s comfort. The interpretation of blood sample results depends on the tests performed and their reference ranges. To correctly interpret the results, the nurse must be aware of normal and abnormal findings as well as factors that affect the results. Factors such as timing and types of food intake, medications, exercise, and proper collection techniques may affect blood results.