Chapter 30
Collecting and Testing
Specimens
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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Specimens (samples) are collected and tested to
prevent, detect, and treat disease.
The doctor orders what specimen to collect and
the test needed.
All specimens sent to the laboratory require
requisition slips.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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URINE SPECIMENS
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The random urine specimen
• The random urine specimen is collected for a routine
urinalysis.
• No special measures are needed.
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The midstream specimen (clean-voided specimen
or clean-catch specimen)
• The perineal area is cleaned before collecting the
specimen.
• Sterile gloves are needed.
• A sterile specimen container is needed.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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The 24-hour urine specimen
• All urine voided during a 24-hour period is collected.
• Urine is chilled on ice or refrigerated during this time.
• A preservative is added to the collection container for
some tests.
• The person voids to begin the test with an empty bladder.
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Discard this voiding.
• Save all voidings for the next 24 hours.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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The double-voided specimen (fresh-fractional
urine specimen)
• The person voids twice.
• The first time the bladder is emptied of “stale” urine.
• In 30 minutes the person voids again.
• Fresh-fractional urine specimens are used to test urine
for glucose and ketones.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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Testing urine
• Urine pH measures if urine is acidic or alkaline.
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Normal pH is 4.6 to 8.0.
A routine urine specimen is needed.
• Testing for glucose and ketones
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These tests are usually done 30 minutes before each
meal and at bedtime.
The doctor uses the test to make drug and diet decisions.
Double-voided specimens are best for these tests.
• Testing for blood
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Sometimes blood is seen in the urine.
At other times it is unseen (occult).
A routine urine specimen is needed.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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Using reagent strips
• Dip the strip into urine.
• Compare the strip with the color chart on the bottle.
• Follow the manufacturer’s instructions.
 Straining urine
• A stone (calculus) can develop in the kidney, ureter, or
bladder.
• Some stones are passed through urine.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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STOOL SPECIMENS
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Stools are studied for:
• Blood
• Fat
• Microbes
• Worms
• Other abnormal contents
The stool specimen must not be contaminated
with urine.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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Testing stools for blood
• Often blood is seen if bleeding is low in the bowels.
• Stools are black and tarry (melena) if there is bleeding in
the stomach or upper GI tract.
• Sometimes bleeding occurs in very small amounts and
cannot be seen (occult blood).
• The test is often done to screen for colon cancer.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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SPUTUM SPECIMENS
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Sputum specimens are studied for blood,
microbes, and abnormal cells.
The person coughs up sputum from the bronchi
and trachea.
• It is easier to collect a specimen in the morning.
Older persons may lack the strength to cough up
sputum.
• Coughing is easier after postural drainage.
• The nurse or respiratory therapist does postural
drainage.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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QUALITY OF LIFE
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Promote comfort by explaining the procedure to
the person.
Some people can collect their own urine and
sputum specimens.
• Doing so promotes independence and helps reduce
embarrassment.
Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.
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