The stool guaiac test finds hidden (occult) blood in the stool (bowel movement). This specimen shows the total amounts of wastes the kidneys are eliminating and the amount of each. Fill out the request form completely with the following information: Family member prefix and sponsor’s social security number, Ward number if inpatient, or mobile number if outpatient, Name of the physician who ordered the culture, Aerosol of 10% sodium chloride or sterile water (optional). 1. Allow the patient to use the wooden applicator or a brush to smear a thin film of the stool sample onto one of the slots in the test card or slide. Oh no! It is one way of knowing about the patient’s health status by identifying pathogens and analyzing urine, blood, sputum, and feces. See Chapter 8 for the nursing implications for antibiotic therapy. Label the specimen container with patient identifying information, and send to the lab immediately. The patient will be asked what kind of medications he is taking, including prescriptions and nutritional supplements. Urinalysisis an extremely valuable tool for diagnosis and screening. Midstream “clean-catch” urine collection is the most common method of obtaining urine specimens from adults, particularly men. Supplies and equipment required to collect a stool specimen are: Clean bedpan and cover (an extra bedpan or urinal if the patient must void), Plastic bag for transport of container with specimen to laboratory. Have periodic audits on urine culture use in intensive care units to look for trends, especially if CAUTI rates there are not dropping with interventions focused on improving insertion and maintenance. Record the amount, consistency, and color of the sputum collected, as well as the time and date in the nursing notes. Instruct the patient to void a small amount of urine into the toilet to rinse out the urethra, void the midstream urine into the specimen cup, and the last of the stream into the toilet. Stools specimen are often tested for blood. The color, density, and odor of urine can reveal much about the state of health of an individual. Blood in the urine colors it; if the amount of blood in the urine is great, the urine will be red. Label the culture tube with the patient’s name, SSN, and ward number if applicable. Draw at least 10 cc of blood from the patient (5 cc is needed for each bottle). Instruct the patient to void directly into a clean, dry container. 25 N Winfield Road Winfield IL 60190 Phone: 630 933-2633 Fax: 630 933-5292. Encourage the patient to take more fluids. This type of specimen is most convenient to obtain. These include vitamin C and nonsteroidal anti inflammatory medicines such as ibuprofen and aspirin. Lessen transport time and maintain an appropriate environment between collection of specimens and delivery to the laboratory. Perineal hygiene. Clean the top of both culture bottles with betadine solution or alcohol swab. Fill out the laboratory request form completely and send the specimens to the laboratory immediately. Sterile syringe (20 cc) and three needles (usually 20 gauge), Two blood culture bottles (one for anaerobic and one for aerobic specimens). After each bowel movement, clean the perineum and urethral meatus from front to back to reduce concentrations of pathogens at the urethral opening. A sample of urine collected at any time of the day. Antibiotic Treatment ï¡ Administer antimicrobial medications as ordered. urine (except in neutropenic patients) + Positive urine culture (bacterial growth in urine culture) 1. According to the FDA, 10 to 20 percent of pregnant women may not detect their pregnancy by testing on what they believe to be the first day of their first missed period. Assist the patient to comfortable position. Identifies causuative organisms in suspected infections of the kidney, ureter, bladder, and urethra â¢Obtain a specimen from the port of an indwelling catheter using sterile technique. The outcome of treatment for UTI is determined by follow-up urinalysis and culture. Urine Culture. The combination of grossly elevated urine glucose and ketones is also considered significant. 1. Instruct the patient to void a small amount of urine into the toilet to rinse out the urethra, void the midstream urine into the specimen cup, and the last of the stream into the toilet. Among patients with discontinued antibiotics, none was diagnosed with a UTI within 14 days of the initial urgent care encounter. ï¡ Instruct patient about good perineal care and cleansing after each bowel movement. A "clean-catch" urine sample is necessary to assure accurate results. If you don’t get an adequate sample on the first try, have him continue to cough until you’re able to collect a minimum of 15 ml. If the patient cannot cough up a specimen, the respiratory therapist can use sputum induction techniques such as heated aerosol (nebulization), followed in some instances by postural drainage and percussion. Tell him to flush the remaining stool down the toilet. Tell the patient that he needs to collect a sample from his bowel by placing a sheet of plastic wrap or paper loosely across the toilet bowl to catch the stool or he can use a dry container to collect the stool. Immediately cover the container and label it with the patient’s name and other needed information. Bring together all supplies and equipment needed to patient’s bedside. If he is not capable of sitting alone, place him in a high-Fowler’s position. On day 1, urinate into the toilet when you get up in the morning. It looks like your browser needs an update. Note: If the urine sample is being taken from an infant, the clean-catch kit consists of a plastic bag with a sticky strip on one end that fits over the baby’s genital area, as well as a sterile container. Always observe proper hand hygiene prior to the test. For instance, the presence of group A streptococcus bacteria in your throat is a key sign that you may have strep throat. For many urine chemistry procedures the specimen of choice is 24-hour urine. â¢The patient voids, and catheterization is performed Exactly 24-hours after beginning the collection, ask the patient to void. How should the specimen be transported? And prepare himself when he feels the urge to have a bowel movement. Urinalysis is easy to un⦠Urine testing or urinalysis is a valuable tool to screen an patient and diagnose their health status. Frail, elderly nursing home residents are often unable to provide midstream voided urine specimens for diagnostic testing. Drink liberal amounts of fluids daily to flush out bacteria. Urine culture is performed to detect the organism that is the causative agent of UTI (urinary tract infection). TMP/SMX for empiric use, however, is often limited by antimicrobial resistance. Learn vocabulary, terms, and more with flashcards, games, and other study tools. It is cheap and simple to perform and can indicate a variety of disorders and diseases (Wells, 1997). Fill out the appropriate laboratory request form completely, noting any special examination ordered. Supplies and equipment required for a blood culture are: The test requires little preparation for the patient. Instruct the patient to repeat the test on his next two bowel movements to improve the accuracy of the test. Tell the patient to separate folds of urinary opening with thumb and forefinger and clean inside with towelettes or cotton balls, using downward strokes only; keep labia separated during urination. ï¡ Tell patient to observe urine ⦠Once you’ve collected the specimen, securely cap the container. A bacterial count of 100,000 or greater per mL of urine, What are some examples of infections from bacteria found in a positive urine culture, Verify orders, identify patient, explain procedure and purpose to the patient, and collect specimen, Label the specimen container, place in a biohazard bag, collect requisition, and transport to the lab. Often, no special handling is required with these samples. A specimen of mucus from the lungs expectorated through the mouth or obtained via tracheal suctioning with an in-line trap or bronchoscope. This type of sample may be used to detect the presence of various substances in the urine at one particular point in the day. In The Most Common Inpatient Problems in Internal Medicine, 2007. Residual urine â¢This is urine left in the bladder after voiding. CATHETER-ASSOCIATED UTI: Fever and suprapubic tenderness Urinary Tract Infections Proud to be a NURSE ANTIBIOTIC STEWARD 2 There is no discomfort when the test is done since it only involves normal bowel function. 6. Instruct the patient to drink adequate fluids during the collection period. Sterile, disposable containers are recommended. 2. Collect all urine voided during the next 24 hours. Since we started in 2010, Nurseslabs has become one of the most trusted nursing sites helping thousands of aspiring nurses achieve their goals. Label the specimen properly and fill out test request form completely. Consumption of certain foods, such as beets or asparagus can impart a characteristic odor to urine. HEALTHLAB. PYELONEPHRITIS: Fever and flank pain 3. RESULTS: During the study period, 910 patients received empiric antibiotic therapy for UTIs but had a negative urine culture result. Close the slots and put the name of the patient and the date on the test kit. Refrigerate the urine sample if it is not to be examined at once. With this, nurses should be knowledgeable enough about the hospital’s policy and procedures for specimen collection. UTI may also take on a foul-smelling odor. Discuss the test and the procedure with the patient. Discuss the test and the procedure with the patient. Expanded cost-per-Medicare beneficiary due to repeated specimen collections and unnecessary treatment. For cystitis, nitrofurantoin or trimethoprim/sulfamethoxazole (TMP/SMX) is preferred. The midstream urine is considered to be bladder and kidney washings; the portion that the physician wants tested. Discuss the procedure and the reason for doing it to the patient. Determine presence of pain noting for ⦠A health care professional may culture your urine to find out what type of bacteria is causing the infection. Zephiran, a soap solution, or three antiseptic towelettes, Three cotton balls (to use with zephiran or soap solution). or sepsis associated with UTI. Painâ Analgesics for urinary pain include phenazopyridine, which ⦠Position your patient in a chair or on the side of bed. Collect the specimen and unclamp the tubing. Only the physician or a registered nurse should tell the patient the results of the test. Urine normally doesn’t have a very strong smell. Don gloves and goggles. Increase fluid intake. Afterward, tell the patient to collect the rest of his urine in the special bottle for the next 24 hours, storing it in a cool environment. Luckily. This hormone can be detected in small amounts in both the urine and the blood of a pregnant woman as early as 10 days after conception. Inject 5 cc of blood into the anaerobic bottle, not allowing air to enter the bottle. 4. Have the patient sit comfortably either on bed or chair while explaining the procedure. It is done to isolate and identify any pathogens, which may be medium. You have entered an incorrect email address! For the clean-catch urine culture, obtain povidone-iodine wipes and a sterile specimen container. If no dangerous bacteria are present in the stool culture but symptoms still exist, other explanations like irritable bowel syndrome, a parasitic infection, or other diagnosis can be explored. Afterwards, collect all urine in a special container for the next 24 hours. If residents present with questionable or mild symptoms, it is preferable to monitor the patient while the urine culture is pending, rather than initiating empiric antimicrobial therapy. The clean-catch urine method is used to prevent germs from the penis or vagina from getting into a urine sample. Generally, the patient will be given one or more containers to collect and store urine over a 24-hour time period. The additional intake will further increase sputum production overnight and assure that you’ll get a good sample. Duplicated specimen collections and re-testing, Decreased ability to provide up-to-date, proper patient care, Unnecessary repeated specimen collection and patient dissatisfaction, Sterile cotton-tipped applicator specimen collection tip (culturette). One of the many responsibilities assigned to us, as nurses, is to collect and label specimen for analysis and to ensure their delivery to the lab. Midstream “Clean-Catch” Urine Specimen, 4.3. UTI is a preventable disease mainly focusing on the hygienic practices of the individual. Wanting to reach a bigger audience in teaching, he is now a writer and contributor for Nurseslabs since 2012 while working part-time as a nurse instructor. Label the specimen cup with the patient’s identifying information, complete a laboratory request form requesting an HCG test and send both to the lab. It is not necessary to keep the specimen sterile because the gastrointestinal tract is not sterile. interventions for CAUTI prevention but did not as directly ... ¥ The option for ÒreßexÓ urine culture from a previously collected urinalysis specimen was eliminated; requiring an assessment of patient symptoms and a new urine specimen to be sent for culture if indicated (11). Send the bottle and laboratory request form to the lab. Pigments and other compounds in certain foods and medications may change the color of urine. A 24-hour urine collection is performed by collecting a person’s urine in a special container over a 24-hour period. It can confirm the presence of harmful bacteria. Possible critical findings are the presence of uric acid, cystine, leucine, or tyrosine crystals. Put on gloves and clean the drawing site with betadine solution or alcohol swab. Advise the patient to use the test the first time she urinate after waking up. Nurse Salary: How Much Do Registered Nurses Make? This will complete the specimen collection. © 2021 Nurseslabs | Ut in Omnibus Glorificetur Deus! 4. Analyses compared culture rates, culture positive rates, and pathogen antimicrobial resistance patterns. The patient may be asked to stop taking certain medications that may alter the blood culture results. Urine culture. Other important points include straining and discomfort, use of drugs, recent surgery, and illness. The amount and kinds of waste in the urine make it lighter or darker. How would the nurse obtain a urine C& S from an indweling urinary catheter catheter? It involves a number of tests to detect and measure various compounds that pass through the urine. However, nurses should not only possess the right knowledge, but as well as the skill and understanding in performing necessary procedures in accordance with the organization’s protocols, policies, and guidelines. Instruct the patient to completely retract foreskin and cleanse penis with towelettes or cotton balls. 3. A health care professional can see how the bacteria have multiplied, usually in 1 to 3 days, and can then determine the best treatment. Place the tissues nearby and have the patient rinse his mouth with clean water to remove any food particles. Send the sample to the lab immediately, without refrigeration. Similar knowledge gaps and misconceptions about the need for urine cultures in patients with urinary catheters exist among physicians. It should be delivered within two hours of collection. Elevated specific gravity. A sample of mucus and secretions from the back of the throat is collected on a cotton-tipped applicator and applied to a slide or a special cup that allows infections to grow. Throat swab culture is done to detect the presence of organisms in the throat that could cause infection. Obtain povidone-iodine solution, sterile towels, and an appropriate sterile tray (paracentesis, thoracentesis, arthrocentesis, bone marrow aspiration). During the intervention, significant reductions in the urine culture and positive culture rates were observed (P = .014). These infections can include strep throat, pneumonia, tonsillitis, whooping cough, and meningitis. Have the patient apply pressure to the site. Fill out the laboratory request form completely, label the specimen container with patient identifying information, and send to the lab immediately. It is very informative material regarding sample collection, please add more examples of specimen like blood etc. Use the same cleaning methods and the plastic bags for collecting the urine. Avoid mixing urine or regular toilet paper into the sample. The most important step in the recovery of pathogenic organisms responsible for infectious disease is the proper specimen collection, processing and handling by you, the healthcare professional. At 7:00 am the next morning, void and add the urine to the collection container. Urine will become more diluted as the patient drink liquids, so hCG levels may be harder to measure later in the day. His goal is to expand his horizon in nursing-related topics. Stool cultures play an important role in understanding and treating intestinal illness. To ensure the best experience, please update your browser. A pregnancy test measures a hormone in the body called human chorionic gonadotropin (HCG), a hormone produced during pregnancy. When urine stands, decomposition from bacterial activity gives it an ammonia-like odor. CYSTITIS: Dysuria, frequency, urgency 2. Ask for someone within the team to assist if the patient is uncooperative. Place the cotton-tipped applicator into the culture tube immediately. Timed Urine Specimens (2-Hour, 4-Hour, 24-Hour), Nursing Test Bank and Nursing Practice Questions for Free, NCLEX Practice Questions Test Bank (2021 Update), Nursing Pharmacology Practice Questions & Test Bank for NCLEX (500+ Questions), Arterial Blood Gas Analysis Made Easy with Tic-Tac-Toe Method, Select All That Apply NCLEX Practice Questions and Tips (100 Items), IV Flow Rate Calculation NCLEX Reviewer & Practice Questions (60 Items), EKG Interpretation & Heart Arrhythmias Cheat Sheet. Media:- nutritive agar plate Method:-Place a [â¦] 24-hour urine sample is needed. Instruct the patient to urinate, flush down the urine down the toilet when he gets up in the morning. As this urine is the most concentrated, it will contain the highest hCG levels of the day. Pour the urine into the sterile container. Remove and discard your gloves and wash your hands thoroughly. Do not allow the patient to eat red meat, any blood-containing food, cantaloupe, uncooked broccoli, turnip, radish, or horseradish for 3 days prior to the test. Allow the patient to tilt his head back and ask him to say “Ahhh.”. Not Treating Asymptomatic Bacteriuria Wash your hands and instruct the patient to do it as well. A stool culture is the process of growing or culturing organisms existing in feces to see if any of them cause disease. Label the bottle with patient identifying information, the date, and time the collection begins and ends. With the use of a tongue blade, transfer a portion of the feces to the specimen container. Specify most common specimen collection procedures, Know the importance of various specimen collection for patient care and satisfaction, Emphasize the importance of protecting yourself against exposure to bloodborne pathogens. Example: Begin collecting the 24-hour urine specimen by voiding at 7:00 am and discarding the urine. The best time to test for pregnancy is after the woman miss her period. To prevent contamination by particles in the air, keep the container closed until the patient is ready to spit into it. A urine culture C& Sis ordered. Guaiac Fecal Occult Blood Test (gFOBT), 4.2. Nurse-led antibiotic stewardship intervention reduces unnecessary urine cultures Study in November 2020 issue of The Joint Commission Journal ⦠The role of nurses in collecting, labeling, and ensuring the timely and proper delivery of specimens to the laboratory plays a very important thing in the hospital setting. Gil Wayne graduated in 2008 with a bachelor of science in nursing. Discuss that this is done to detect the presence or absence of infecting organisms and, therefore, must be free from contaminating matter that may be present on the external genital areas. If you can’t obtain the sample before the patient has breakfast, though, wait at least an hour after he’s eaten before trying.