Specimen Collection Notes

Policies and Practices for Specimens 

  • A specimen is sample that represents a whole

  • What are different types of specimens that can be obtained? Urine, stool, sputum, culture, blood

  • What is point-of-care testing (POCT)? Allows patients to be tested and diagnosed in physician’s office, ambulances, homes, urgent care, and the hospital 

  • What is the purpose of quality control testing? To make sure that the equipment is working properly

  • What is calibration? The act of making sure the laboratory instruments are producing accurate results

  • What regulates laboratory testing? CLIA (clinical laboratories improvement amendments) 

  • Describe CLIA-waived tests. No special certification required, unlikely to be incorrect, no risk/harm; COVID, flu, pregnancy, ovulation, blood glucose

  • What tests are assistants certified to perform? CLIA-waived



Safety Precautions

  • What are specimen tests used for? To diagnose diseases (diagnosis) 

  • Why is patient education important? The procedure is followed and the patient is not harmed 

  • Gloves should be worn during specimen collection

  • What must be done if a health care worker comes into contact with a patient’s blood or bodily fluid? Wash the area and report it 

  • What kind of information should be included on the label? Name, room number/address, specimen type, physician can never put the label just on the lid 



Routine Urine Specimen

  • Why is urine from the first void of the day most often used in routine urine specimen? It is more concentrated

  • How much urine is poured into the specimen container? 4 oz; around 120 ml



Clean-Catch Urine Specimen

  • What is a clean-catch urine specimen? Clean genital area then collected urine mid-stream

  • Perineal care should be performed prior to obtaining a sample

  • How much urine should be collected? 30-60 ml (1-2 fluid oz)



24 Hour Urine Specimen 

  • What is a 24-hour urine specimen? Urine produced in a full day that is collected (all drops)




  1. Begin on second void

  2. Collect all voids through to the first void of the following day 

  3. Store in a 24-hour specimen container 



  • What is a 24-hour urine specimen used for? Check kidney function; detecting unusual amounts of proteins, hormones

  • When should a 24-hour specimen begin? After the patient’s first void

  • Where should the container be stored? On ice; if at home, in the fridge



Pediatric Urine Specimen

  • What is a pediatric collection bag? Clear bag with a skin-adhesive backing around the opening 

  • What is done if a 24-hour urine specimen is needed? Wee bag with a tube that runs/drains into a container

  • How often should the child be checked? 10-15 minutes



Straining Urine

  • Why might urine need to be strained? If the patient has kidney stones

  • Who is at risk for developing stones? Caucasian man between 20-40 years old

  • What is done with the stones once they are passed? Sent to a lab for examination



Urinalysis 

  • What is urinalysis? Analysis of urine

  • Which tests are CLIA-waived? Physical urinalysis

  • What are the four areas of physical assessment? Color, odor, clarity, specific gravity



Pale - urine is diluted 

Dark Yellow or Orange - urine is concentrated 

Brown - jaundice or hepatitis 

Cloudy Red - hematuria 

Clear Red - presence of hemoglobin 




Ammonia - specimen is old

Foul or putrid - presence of bacteria or infection 

Sweet or fruity - diabetes or the presence of acetones or ketones 



  • What can cloudy or milky urine indicate? - presence of mucus or pus; presence of lipids

  • Specific gravity is the concentration of urine 

  • If the specific gravity is not between 1.003 and 1.035, it may indicate disease 

  • What can an increased specific gravity indicate? Diabetes, dehydration

  • What can a decreased specific gravity indicate? Kidney disease, high fluid intake, diuretic medications

  • What is commonly used to chemically test urine? Use reagent strips 

  • How do reagent strips work? Dip into urine, pull it out, let it dry, read it 

  • What substances do reagent strips commonly test for? Glucose or blood

  • What is a normal pH for urine? Between 5.5 and 8

  • Bilirubin is the result of broken-down red blood cells and may indicate liver disease or bile duct obstruction 

  • Urobilinogen is converted bilirubin, and large amounts may indicate disease of the heart, spleen, or liver

  • Glucose found in urine may indicate: kidney disease, diabetes

  • Ketones in the urine may indicate: diabetes, starvation, fasting, dieting, high-fat diet, metabolic disorders

  • Protein in the urine may indicate: kidney disease

  • Blood in the urine may indicate: internal injury, infection, kidney disease, urinary tract infection 

  • What temperature should urine be for urinalysis? Body temp/fresh (not cold)



Urine Pregnancy Test

  • What hormone do urine pregnancy tests detect? hCG

  • When can hCG first be detected in urine? 6-12 days

  • What symbols are commonly shown to verify pregnancy? +

  • Why is the first-morning void preferred? Most concentrated 



Stool Specimen

  • Why are stool specimens obtained? To test for anything abnormal

  • How is a stool sample collected from a non-ambulatory patient? In the bedpan

  • How is a stool sample collected from an ambulatory patient? In a “hat” in the toilet 

  • How is a stool sample collected from infants and young children? Collected from diaper

  • How much stool is needed for a stool sample? 2 tablespoons



Testing Stool Specimen

  • What are specimens often examined for? Ova, parasites, blood, lipids, microorganisms

  • Occult Blood is blood from the intestinal tract and may indicate colon cancer

  • How long does a result take? 1 - 2 minutes

  • What color indicates the presence of occult blood? Purple or blue 




Throat Culture

  • What kinds of infections can throat cultures be used to detect? Strep and flu

  • What is a culturette? A big Q-tip

  • Taking a throat culture can cause some paTients to gag or vomit



Wound Culture

  • Where are wound cultures usually taken from? Wound that shows signs of infection

  • What is used to perform a wound culture? Sterile swab

  • Wound cultures are not CLIA-waived procedures



Sputum

  • What is sputum? Mucus expelled from the respiratory system

  • What are sputum cultures used for? Identify microorganisms in the respiratory system

  • What are some conditions that can be diagnosed through a sputum culture? Pneumonia, bronchitis, lung cancer

  • How is a sputum collection done? Deep cough, suction

  • How much sputum should be collected? 1-2 tablespoons