Steps By Nurses During Collecting of Patients Specimens

COLLECTION OF SPECIMENS – NURSING RESPONSIBILITY

Collecting specimens is a collaborative nursing responsibility.  Usually, the physician orders the tests and the Nurse collects and  sends  the specimens to the appropriate laboratories.

In some hospitals, the Nurse is authorized to collect and send specimens when he or she judges the clients, condition, suggests further analysis, in either event the nurse should follow these general guidelines for collecting specimens.

  1. The Nurse is responsible for:

–     Knowing the nature of the test

–     Knowing why the client is having the test

–     Ensuring appropriate preparations (such as fasting)

–     Collecting the specimen at the correct time

–     Collecting the specimen in the correct container without contamination

–     Sending the specimen to the laboratory for testing within the required time frame, with the agency requisition information, land in the required condition

  1. The Nurse assess the client for

–     Understanding of the test

–     Degree of comfort concerning the specimen required

–     Ability to participate in the collection of the specimen

  1. The Nurse teaches the client about the test purpose and procedure if he or she does not understand
  2. The Nurse provides emotional support if the client expresses fear or anxiety about the test itself or its results

INVESTIGATIONS AND OBSERVATION OF FAECES

FAECES – this is a bowel excretion of the waste product of metabolism.

METHOD OF COLLECTION:

A freshly passed stool uncontaminated by urine is required.  The ideal specimen bottle should have a small scoop the specimen is taking from the bed pan into the bottle and corked ready for the laboratory examination.

In the absence of this an ordinary bottle (Vaseline jar) with a cork and a wooden spatula with which to take stool from the bed pan into the bottle are then labeled and sent to the laboratory.

METHOD OF DISPOSAL:

The remaining stool in the bed pan is first flushed with cold water in the sluice to avoid coagulation of protein since all human exudates contain protein.  Warm soap water is again used with a long brush and then flushed with cold water.  It is then boiled and kept back in the rack.

LABORATORY INVESTIGATION

Microscopic examination reveals the presence of white blood corpuscles, pus cells, various intestinal parasites and worms.  The stool may be examined after staining, estimation and fat balance.

Chemical examination may present occult blood as seen in condition of bleeding peptic ulcer.  Bright red blood indicates bleeding from low alimentary tract (cases of carcinoma of rectum) dysentery, haemorrhoids and colitis.

VOMITUS

DEFINITION: Vomiting is a reflex action which results in the content of the stomach being ejected our through the mouth.

 

METHOD OF OBSERVATION OF CLIENTS VOMITUS.

Quantity:       It depends on the amount of the individual can produce.

CHARACTERISTICS/ABNOMALITIES OF VOMITUS

The character should be observed whether it was ejected forcibly or gradually.  If forcibly and accompanied by a lot of noise, it is known as projective vomiting.  It usually occurs in intestinal obstruction.

 

CONISTENCY

It depends on what the individual brings out.  It may contain purely undigested food particles or worms.

COLOUR

It can be greenish indicating the presence of bile.  This is seen in client with an empty stomach such as client under anaesthesia.  It can be blood stained indicating straining of the walls.  When fresh blood is vomited, it is known as haematemesis.  Thus unlike haemoptysis (coughing out of blood) there is no air bubble or frothiness.

ODOUR

If the vomitus does not have a foul smell it indicates there is obstruction in the intestinal tract.

LABORATORY INVESTIGATION

The vomitus of a clients suspected of poison should be analyzed for poison while that of a peptic ulcer should be analyzed for occult blood.

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