copyright ©2012 delmar, cengage learning. all rights reserved. chapter 46 specimen collection and...

Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Chapter 46

Specimen Collection and Processing


Urine Specimen

• First morning • Midstream clean-catch • 24-hour• Pediatric collection• Urinary catheterization


Chain of Custody

• Collection of urine specimen for substance abuse analysis

• Detects the presence of illegal drugs and chemical substances

• Chain of custody forms must be filled out and procedure followed


Pregnancy Testing

• Measures the amount of human chorionic gonadotropin (hCG) in urine or blood

• Most commonly performed on urine at home and in the POL


Urinalysis

• Three components– Physical– Chemical– Microscopic


Physical Urinalysis

• Color• Clarity• Volume• Odor


Chemical Urinalysis

• Analyze specimen as soon as possible after collection

• Reagent strips provide qualitative and quantitative assessments


Chemical Urinalysis

• Strips are compared to known values on the bottle for reporting


Normal and Abnormal Values

• pH • Protein• Ketone• Bilirubin• Urobilinogen

• Hematuria• Nitrite• Leukocyte esterase• Glucose• Specific gravity


Microscopic Examination

• MAs may prepare the slide for the provider to view and report results– Centrifuge urine tubes– Pour off supernatant– Collect sediment and place on slide

• The MA does not read or interpret results of microscopic urine specimen


Fecal Specimen

• Used to check for occult blood, ova and parasites, bacterial and viral infections

• Stool specimen are difficult for patients to collect properly

• Instruct patients to obtain specimen at home and bring to lab for testing


Fecal Specimen

• Occult blood specimen– Common screening tools for early detection of

colon cancer– Test uses a guaiac reagent


Bacterial Specimen

• Bacteria, viruses, and fungi are extracted from specimen for identification, to determine the appropriate treatment

• Culture is taken from the part of the body that is infected– Collected in a culturette


Bacterial Specimen

• Culture sites– Throat– Mouth– Ear– Eye

– Nose– Vagina– Anus– Infected Wounds


Throat Culture

• Taken from patients complaining of sore throat, fever, swollen glands, and cough

• Rapid Group A strep kits provide results in minutes


Blood Cultures

• Blood is drawn from patient directly into a particular formulated broth in a vacuum bottle

• When a blood culture is positive, this indicates a systemic infection and requires immediate attention


Culture and Sensitivity

• Specimen is collected and inoculated in special media (agar) to encourage growth of microorganisms

• Sensitivity tests the organism against different types of antibiotics


Culture and Sensitivity

• Media comes in petri dishes, tubes, and broths– Primary media encourages the growth of all

microorganisms– Selective media discourages the growth of certain

microorganisms


Gram Staining and Microbiologic Smears

• Used to help identify a bacterial specimen• Bacteria specimen are sorted into two groups

– Gram positive• Dark blue to violet after staining

– Gram negative• Red or pink after staining• More dangerous connotation than Gram positive


Morphologic Shapes

• Three basic shapes– Coccus– Bacillus– Spiral


Morphologic Shapes

• Gram positive cocci in clusters– Staphylocci

• Gram positive cocci in chains– Streptococci

• Gram negative cocci in pairs– Neiserria gonorroeae

• Gram negative bacilli– Escherichia coli

copyright ©2012 delmar, cengage learning. all rights reserved. chapter 46 specimen collection and...

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