Ch 42 Specimen Collection and Processing

Urine container labeling requirements

Patient’s name, date of collection, time of collection, and the test(s) to be performed.

Best urine sample for testing

First morning urine sample, because it is most concentrated from being held overnight.

Catheterization indications

When a sterile specimen is needed, the patient cannot void, or medication must be instilled.

Substance abuse analysis timeframe

All drugs consumed within the 30 days prior to testing are likely to be revealed.

Pregnancy test purpose

To measure the amount of human chorionic gonadotropin (hCG) in the blood or urine.

Urinalysis composition

The most frequently performed test, consisting of physical, chemical, and microscopic testing.

Stool specimen instruction

Essential for the medical assistant to explain properly because it provides great diagnostic insight.

In-office culture next step

It can be sent out for a culture and sensitivity (C&S) test.

What is a culturette?

A sterile swab with a soft tip, protected by a plastic sleeve, used to collect cultures from various sources; an ampule is crushed to protect the integrity of the specimen after collection.

When obtaining a throat swab for group A strep screening, what is the proper procedure for performing the swab?

Do not allow the swab to touch the tongue, teeth, lips, or gums; guide the swab to the peritonsillar crypt area and collect any exudate you observe.

Identify three elements of a complete urinalysis.

Physical

• color, clarity/turbidity, odor, specific gravity

Chemical

• pH, protein, glucose, nitrite and leukocyte esterase for potential UTI, blood, bilirubin and urobilinogen

Microscopic

• cells, casts, crystals, microorganisms

Discuss the differences among random, first morning, clean-catch midstream, and 24-hour urine specimens

Random:

• Collected at any time of the day without special preparation

First morning specimen:

• Collected when the patient first wakes up in the morning and is the most concentrated, yielding the most accurate results

Clean-catch midstream:

• Requires the patient to clean external genitalia prior to collection of the specimen

24-hour specimen:

• Requires patient to begin timing from the first morning specimen at the onset of the 24-hour period, discard that specimen, and collect all subsequent specimens within the 24-hour time period

Name the three morphologic shapes and provide a description of each.

(1) Coccus—berry-shaped or round;

(2) Bacillus—rod-shaped;

(3) Spirochete—spiral-shaped

Which conditions might be diagnosed in a sputum specimen?

Cancer, tuberculosis, bacterial infections, fungal infections, and viral infections

Normal fecal occult blood test (FOBT)

Test Results Breakdown

• Normal (Negative):

  • No blood was detected.

  • If you were doing this for routine colorectal cancer screening, your risk is currently low.

  • Guidelines generally recommend repeating the test every year.

• Abnormal (Positive):

  • Blood was found, which requires further investigation.

  • A positive result does not automatically mean cancer.

  • Other common, benign causes include hemorrhoids, ulcers, polyps, or inflammation in the gastrointestinal tract.

  • Doctors will typically recommend a follow-up test like a colonoscopy

What is SSA test used for?

Sulfosalicylic Acid (SSA) test is a simple laboratory method used to detect and measure the amount of protein in urine.

• It is primarily used as a confirmatory test to verify the results of standard urine dipsticks, and is more sensitive because it detects albumin, globulins, and Bence-Jones proteins

What is Acetest used for?

The Acetest is a semi-quantitative urine test designed to detect the presence of two key ketone bodies: acetoacetic acid and acetone.

• It is typically used by healthcare professionals to confirm or monitor conditions like diabetic ketoacidosis (DKA) or starvation ketosis

What is Ictotest used for?

The Ictotest is a diagnostic urine test used to confirm the presence of conjugated bilirubin, a marker often used to evaluate liver function.

• It is typically ordered by a healthcare provider when a routine urine dipstick shows a positive result, as it helps rule out false positives and has a much higher sensitivity than standard dipsticks.

Hematuria

Hematuria is the medical term for the presence of blood cells in your urine.

• It is categorized as either gross (visible to the naked eye, turning urine pink, red, or cola-colored) or microscopic (detectable only via laboratory urine tests)

What is Human chorionic gonadotropin?

(hCG) is a hormone primarily produced by the placenta shortly after implantation.

• Widely known as the "pregnancy hormone," it sustains early gestation by supporting progesterone production, and its detection in blood or urine serves as the basis for pregnancy tests