Urine collection from Catheter and Midstream Assessment 1.

Assess patient and families understanding of purpose of test and methods of collection. 2. Assess signs and symptoms for UTI 3. Refer to medical record for indication of UTI Asses risks for UTI such as poor perineal hygiene 4. Refer to agency procedures for specimen collection method 5. Complete procedure-related assessment Clean-voided specimen- assess mobility, balance and coordination in being able to clean own perineum and use toilet facilities independently Sterile specimen from catheter Assess indwelling catheter for type of built in sampling port and type of material made Evaluation 1) Observe urine and contaminants such as toilet paper or feces 2) Assess pt urine culture and sensitivity report for bacterial growth 3) Observe urinary drainage system to ensure that it is intact and patent 4) Ask pt to describe midstream urine collecting procedure Client teaching 1. Clean perineum before 2. If agency s policy indicates use sterile water to clean 3. Initiate urine stream into toilet after stream achieved, pass specimen container into stream and collect 30 to 60 mL. 4. S&S or UTI 5. For women cleaning from front to back Urinalysis from an infant Use a sterile plastic urine collection bag that adheres to the perineum. For male, place penis and scrotum inside the bag. Clean the perineum, use soap and water to decrease contamination- midstream urine collection.

Swab for C & S Stool Collection

Assessment : 1. 2. 3. 4. 5. Assess patient and family understanding of need for a stool test. Assess patient s ability to cooperate with procedure and collect specimen Assess medical history for bleeding, GI disorder, hemorrhoids. Note any drugs patient is taking that can cause GI mucosal bleeding. Refer to health care provider order for medication or dietary modifications or restrictions before test.

Evaluation : 1. Ask patient to explain collection procedure. 2. Note colour changes in guaiac paper. Client Teaching 1. Explain reason regarding why patient needs to obtain specimens from 2 different areas of stool specimen. 2. If pt has been on long term steroid or anticoagulants drugs, explain how these drugs may result in occult blood in stool. 3. If health care provider orders meat-free diet before test, explain that red meat can cause false positive. 4. Discuss reason for multiple testing of stool for occult blood. Usually obtain specimen every day for 3 days. Sputum Collection Assessment Check health care providers order for type of sputum analysis and specification (amount, number, time, method to obtain). Assess patient s level of understanding of procedure and its purpose. Assess when patient last ate a meal (+wait 1 to 2 hours after eating). Determine type of assistance needed by patient to obtain specimen. Assess respiratory status, including rate, depth, pattern and colour of mucous membranes.

1. 2. 3. 4. 5.

Evaluate 1. Observe patien ts respiratory status throughout procedure. 2. Note anxiety 3. Observe characteristic of sputum: colour, consistency, odour, volume, viscosity or presence of blood. 4. Refer to lab report for results

5. Evaluate pt ability to describe sputum collection process. Teaching consideration Nurse can show proper splinting techniques for postoperative patients. Blood Culture Assessment: 1) Determine patient s understanding of purpose and method you will use. 2) Determine if special conditions need to be met before specimen is collected 3) Assess patient for possible risk associated with ventipuncture: anticoagulant therapy, low platelet count, bleeding disorder. 4) Determine pt ability to cooperate with procedure. 5) Assess pt for contaminated sites for venipuncture: pressure of IV fluid, hematoma at potential site. 6) Review health care provider s orders for type of test. Evaluation: 1. 2. 3. 4. Reinspect venipuncture site. Determine if pt remains anxious or fearful Check lab report for test results Ask pt to explain purpose of test.

Teaching Consideration Instruct pt to briefly apply pressure to ventipunture site. If pt has bleeding disorder they should apply pressure for at least 5 minutes. Instruct pt to notify nurse if persistent or recurrent bleeding or expanding hematoma occurs at the venipuncture site.