Collection of Specimens: Stool, Urine, and Sputum

Urinary Analysis (UA)

Abbreviated as UA, it checks for bacteria in urine.
If bacteria are present, it indicates a urinary tract infection (UTI).
Other reasons for urine collection include checking sugar levels, kidney function, electrolytes (sodium, potassium), and drug levels.

Always wear appropriate personal protective equipment (PPE) when collecting samples.
Determine how to collect the sample and what to store it in, following the nurse's directions.
Use the correct container for the specific test.
Verify the required amount of urine or stool.
Consider timing requirements (e.g., first morning void, specific intervals).
Assemble all supplies beforehand (container, biohazard bag, commode hat, PPE).
Label the container or biohazard bag with date, time, resident name, and date of birth before obtaining the sample.
After collection, place the sample in a biohazard bag, remove gloves, perform hand hygiene, and transport the sample to the nurse or designated storage area.
Refrigerate samples if needed until processed; alert the nurse upon completion.

Collected for various reasons; the most common is urinary analysis (UA) to detect bacteria indicating a UTI.
Other reasons include checking for sugar, kidney function, electrolytes, and drug levels.

Used to check for a UTI.
The resident must be able to sit on the toilet or commode.
If the resident cannot sit, the nurse must perform straight catheterization.
Never obtain a clean catch urine sample from a bedpan, urinal, or commode to avoid contamination.
Contaminated samples would reflect bacteria in the collection item, not the urine.

Clean the resident's peri-area with an antiseptic towelette in a front-to-back motion, wiping from the urethra toward the anus three times.
Some containers include povidone-iodine swabs instead of towelettes.
Ask the resident to start and stop voiding.
Place the cup under the urethra without touching the body.
Instruct the resident to continue voiding and fill the cup to the level indicated by the nurse (usually at least 50 mL).
If the resident cannot start and stop, collect after voiding has started and remove before voiding stops.
Place the lid without touching the inside, and place the container in a biohazard bag.
Attend to the resident's needs and transport the sample to the nurse or designated storage area.

Required for residents with kidney stones.
Collect all urine using a commode hat placed in the front half of the toilet or commode under the seat.
Remind the resident to discard used toilet paper in the wastebasket.
After voiding, empty the commode hat contents through a strainer into the toilet.
Inspect the strainer for stones (which may be small).
Place any found stones in a labeled container, seal the lid, and place it in a biohazard bag.
Give the sample to the nurse or place it in the designated storage area.

Necessary for residents with digestive problems or diarrheal illnesses.
Stool is not sterile, so samples can be collected from commodes, commode hats, and bedpans if they are new and unused.
Avoid urine contamination.
If assisting a male, have him void in a urinal first; for a female, have her empty her bladder first.
Use a commode hat or bedpan to collect the stool.
Follow the nurse's instructions on the number of samples needed.
Place the commode hat under the seat in the back half of the toilet or commode.
Instruct the resident to put used toilet paper in the wastebasket.
After defecation, collect the sample using a wooden tongue blade or plastic spoon from three different areas (ends and middle).
Fill the specimen cup as directed by the nurse, seal the lid, and place it in a biohazard bag.
Give the sample to the nurse or place it in the designated storage area.

Small tubes with screw tops and a spoon attached to the lid.
Scoop the stool into the container, mix it with the fluid inside, and fill to the indicated line.
Seal the lid and place the container in a biohazard bag.
Give it to the nurse or place it in the designated storage area.

Occult blood is "hidden" blood in the stool.
Tests include stool guaiac, fecal occult blood test (FOBT), Hemosure, and Hemoccult.
The nursing assistant may or may not be permitted to perform this test based on facility protocol.

After bowel movement in a bedpan, commode pan, or commode hat, collect a small stool sample with the provided stick or tongue blade.
Wipe the stool on one area of the Hemoccult card under window A, and close the flap.
Take a second sample from a different area and wipe it under window B, and close the flap.
Turn the card over and drop the prescribed amount of developer over the front window.
Follow the manufacturer's directions, as tests may vary.
A blue color usually indicates a positive result for occult blood.
Place the card in a biohazard bag and give it to the nurse for further assessment.
If frank or occult blood is observed during toileting, do not flush the toilet and inform the nurse; a large amount of frank blood or visible rectal bleeding is a medical emergency.

Required for residents with respiratory illnesses to identify the proper treatment.
Sputum is mucous expelled from the lungs, which is colored and thick (unlike saliva, which is clear and thin).
The nursing assistant reinforces instructions from the nurse and provides a sterile container.
Remind the resident to deposit sputum (not saliva) into the container when coughing and to call the nursing assistant to collect the container after obtaining the specimen.
Follow the principles of collection, transport, and infection control.