CHILD HEALTH NURSING
Specimen / sample collection
By : gouri Nandrekar
[(T.Y. BSc (nursing)]
DEFINITION
specimen collection is collecting a small quantity of a substance or object
which shows the kind and quality of the sample.
Types of sample collection
➢ Blood sample collection.
➢ Urine sample collection.
➢ Stool sample collection.
➢ CSF collection.
➢ Biopsy.
PURPOSE
• Blood sample collection
▪ To test blood glucose, electrolyte, mineral, hormone, blood gas level,
etc.
▪ To determine complete blood count.
▪ To find cause of infection.
▪ For confirming organ function.
▪ To diagnose the disease.
• Urine sample collection
• To check for hematuria.
• To check renal functioning and diagnosis
• To check urine for presence of sugar,
acetone, bacteria, protein, and albumin.
• Stool sample collection
• To check stool for presence of blood,
Ova parasite, bacteria or virus.
• CSF sample collection
• Diagnostic :-
diagnosis of malignancy, infection
of cerebrum, cerebellum, meninges
etc.
• Therapeutic :-
for intrathecal drug administration.
• Research :-
measurement of drug level.
INDICATION OF SAMPLE
COLLECTION
• Hemodynamically unstable patient.
• Pyrexia of unknown origin.
• Unexpected leukocytosis.
• Systemic and local infection.
• Hypoglycemia, hyperglycemia .
• Arterial blood gas analysis.
• Oxygen saturation and pH .
• Oliguria, oedema of limb and body.
• Progressively dropping hemoglobin level.
• Chronic and acute illness.
PREPARATION OF PATIENT
• Identification
• Introduction of procedure
• Explain the importance of procedure
• Take a consent
• Examine the patient
• Preparation of skin
• Take patient in appropriate position
• Check all articles needed for procedure
PREPARATION OF ARTICLES
• For blood sample
• Clean tray containing
• Alcohol swab
• Scalp vein
• Disposable syringes
• Tourniquet
• Bowl with cotton swab
• Antiseptic solution
• ABG syringe
• Kidney tray
• Blood collection tube
• Sterile container
SCIENTIFIC PRINCIPAL
• Anatomy physiology :-
site of venous blood sample collection
✓ cephalic vein
✓ median vein
✓ Basilic vein
✓ metacarpal vein
Site of arterial blood sample collection
✓ redial artery
✓ brachial artery
✓ femoral artery
✓ dorsalis pedis artery
• Urinary / renal system
• Urine is composed of water, urea, creatinine, uric
acid, potassium, sodium chloride, ammonia,
phosphate. The kidneys are bean shaped organ
which help to remove waste product from body,
maintain electrolyte balance and regulate blood
pressure.
central nervous system and C.S.F.
▪ cerebrospinal fluid is a clear colorless watery fluid
around brain and spinal cord in the subarachnoid space.
It provide protection and nourishment of brain.
Microbiology
➢Site should be cleaned with antiseptic solution swab.
➢Culture sample should be collecting before
administration of antibiotics
➢Collect the sample in sterile container.
➢Container should be leak proof.
• Physics and chemistry.
➢ storage should be done in cold environment
➢ tourniquet should not too tight which can obstruct
blood supply.
➢Adjust height and bend from knees instead of back
to avoid strain on body.
➢ disinfectant solution should be away from reach of
patient.
• Psychological.
➢ always explain the procedure and get consent
to gain confidence and cooperation.
➢Privacy should be provided while collecting
sample.
➢ always give positive feed back
➢ do not allow the relatives while doing
procedure
STEPS FOR BLOOD
SPECIMEN
• Hand washing before procedure
• Check the physician's order
• Identify the patient
• Explain the procedure and get written
consent
• Wash hands and put on gloves
• Examine the vein and palpate
• Apply the tourniquet
• Clean the skin
➢ Hold the syringe between thumb and first finger with
the level up and directly in line of vein
➢ Insert the needle quickly and smoothly under the
skin into vein and obtain blood sample gently .
➢ Release the tourniquet as soon as specimen
obtained
➢ Apply the sterile gauze pressure on punctured
vein
➢ Remove the needle gently from syringe eject
the blood sample into appropriate container.
CAPILLARY BLOOD SAMPLING
• The pulp of the finger or heel, particularly in newborn can
be used for collection of capillary blood.
• Warm the heel with a cotton swab, soaked in sterile water
at 40 degree temp.
• Dorsiflex the foot and make the heel pulp stand prominent.
• Clean the skin with spirit
• Make a bold prick over one of the side of heel but avoid
using apex of heel because painful scar may cause
difficulty in walking.
• Wipe away the first drop of blood.
• Allow the subsequent drop to fall freely straight into
container.
ARTERIAL BLOOD COLLECTION
▪ Palpate the radial, brachial or femoral artery.
▪ If radial artery is selected perform Allen test.
▪ Place a small towel below wrist and extend up to
20 – 30 degree to make it prominent.
▪ Feel the radial artery and palpate for maximum
pulsation with middle and index finger.
▪ Insert the needle at 45 – 60 degree angle to the
skin surface and collect the sample
▪ After blood is obtain withdraw needle and apply
pressure over puncture site with dry sponge for 5
min
COLLECTION OF URINE
SAMPLE
➢ Check the physician order
➢ Identify the patient
➢ Explain the procedure to the patient
➢ Explain to wash the genital area to prevent contamination
➢ Ask the patient to direct the first and last part of the urine
stream into urinal and collect the middle part of the
container
➢ Place the container in proper place
➢ Place the specimen into specimen box ensure proper
labeling.
➢ Send specimen to laboratory
➢ Remove gloves and wash hands
➢ Do the recording and reporting
COLLECTION OF URINE FROM
CATHETER OR URINE BAG
• Sample collection can be done from the
sampling port found on the tubing
• Clamp the catheter below the port
• Clean the port with an alcohol swab
• Insert the syringe tip into the sampling port
and withdraw the urine
• Remove the clamp once the procedure over
• Collect the sample in sterile container label
and send to lab.
STOOL SAMPLE COLLECTION
• Give bed pan for patient to pass urine
only
• Give clean bed pan to pass the stool
• A small amount of stool is removed
with a stick or spatula and placed in a
specimen container.
• Discard the stick in the waste bin
CSF COLLECTION
• This is an sterile procedure
• Wash hands
• Infiltrate skin and deeper tissue with 1% lignocaine
• Review the tray set up ensure lids of collecting containers are unscrewed
and container are rarely available
• Review the patients position and restrain
• Identify L 3-4 ,or L3-4, inter space and insert the spinal needle
with stylet in place along the midline with level facing upward
• Proper alignment of the needle is added by placing the thumb of non
inserting hand on the spinous process above the inter space being used.
• Direct the needle along the imaginary line toward the umbilicus
• Collect approximately 0 – 1 cc of csf sequentially in each sterile tubes
• Remove the LP needle and apply pressure over the puncture site
NURSES RESPONSIBILITY
• Preparation of patient
• Taking informed consent
• Preparation of environment
• Preparation of article
• Sending the sample to lab
• Ensure the patients identification label
on sample
• Finding the result
• Inform to the physician