Types of specimen collected include:

Blood
Urine
Stool
Sputum
Vomitus

Note: A nurse is directly responsible for

ensuring that specimens are accurately
obtained, correctly labeled, collected in
appropriate containers and transferred to the
laboratory in time for diagnostic procedures
 BLOOD
The indications for the collection of blood spec-
imen include: anemia, infective conditions e.g.
septicemia, fever, hemorrhage and so on.
Collected through:
Vene - puncture
Capillary puncture
Procedure for Collection of Blood
Specimen
Requirements
Disposable lancet or sterile needle, dry sterile
swab, scissors, receiver for used swabs, alcohol
swabs, pipette or tubes, disposable gloves, lab
request forms
Steps
• Read physician’s instructions
• Collect required equipment
• Identify the patient, introduce yourself and
explain the procedure
• Wash hands and put on gloves
• Clean the area for blood collection
• Prick the vein/capillary and collect the re-
quired amount
• Label the container
• Clear the equipment, remove gloves, wash
hands
• Send specimen to the lab together with re-
quest form
 URINE
Characteristics of Urine
It is amber/straw in color
Slightly acidic with a pH of 4.6 – 8
Has specific gravity of 1.010 – 1.030
Has a characteristic odor
Sediments include phosphates (white) and uric
(pink)
It is transparent
In composition: 96% water, 2% urea, 2% salts
and other substances
Abnormalities of Urine
1. Amount
Polyuria: More than 2500mls/24hrs, common in
diabetic patients and those with kidney prob-
lems
Oliguria: Reduced amount 30mls/hr, occurs in
dehydration, cardiac and kidney disease
Anuria: No urine, which can occur in severe
kidney disease and in obstruction of urinary
tract
2. Color
Bright red indicates bleeding from urinary
bladder and urethra
Dark red indicates bleeding from ureter and
kidneys
Dark green indicates presence of bile
Yellow indicates presence of bilirubin
Opaque/milky shows infection
Note: Some drugs can change urine color
[Link]
It can become alkaline if left to stand for long
periods of time. This is called decomposition of
urea.

4. Contents
There can be glucose (glycosuria), protein (pro-
teinuria), acetone, bile, blood, pus, mucous

5. Odor
An offensive smell indicates infection
A faulty smell is often [smelling like fruit or nail
polish (remover)] indicates presence of acetone
6. Specific gravity
When high, indicates glycosuria, when low in-
dicates kidney failure

7. Clarity
When cloudy, indicates infection
Types of Urine Specimen
a) Random Specimen
This is collected at any time of the day and it is
used for routine screening test
If voided at home, should reach the laboratory
within 2 hours

b) Early Morning Specimen

Collected upon rising up before taking break-
fast
This is the time it is mostly concentrated and
specimen is ideal for pregnancy diagnostic test
(PDT)
c) Double Voided Specimen
The patient is instructed to empty bladder and
take fluid if possible
The patient then voids and a sample is then
taken for testing
This ensures the sample is fresh thus a valid
indicator of current blood glucose or acetone
Tests glucose and acetone
d) Clean Midstream Urine Specimen
It helps to avoid contamination of sample with
urethral cells, mucus and micro – organisms
Perineum is cleaned with antiseptic then pa-
tient voids into the toilet about 30mls then into
a container and the rest of the urine into the
toilet

e) Admission Urine Specimen

A routine urine specimen collected on admis-
sion of a patient
f) 24hour Urine Specimen
The patient’s urine is collected over a 24 hour
period and measured
The whole amount is then sent to the lab

g) Sterile Urine Specimen

This is collected directly from urinary bladder
using a catheter
Procedure for Urine Collection
Indicate the purpose e.g. test for UTI, PDT test
Requirements
Specimen containers
Lab request form
Measuring jar/jug
Gloves
Sterile syringes and needle
Urine bags for infants and babies
Toilet paper
Preparation
Explain the procedure to the patient
Ensure privacy
Assemble required equipment
Wash hands and put on gloves
Steps
1. Routine Specimen
Instruct patient if able to pass urine into a
clean reservoir e.g. bed pan, urinal
Pour the required amount into the specimen
container
Take care not to soil the outside of the con-
tainer prevent cross contamination
Incase a patient is a male infant, use a test
tube.
If female infant either apply a sterile pad over
the genital area, squeeze the urine soaked
part with sterile forceps into the container
OR use a urine bag for infants, a special col-
lection bag that has adhesive surface
2. Midstream Specimen
Ask the patient to clean the genitalia with anti-
septic or assist
This provides a cleaner specimen as it clears
the micro – organisms up or near the meatus
Instruct the patient to pass the 1st flow into the
toilet, about 30mls, then middle flow into a
container and the last flow into the toilet
3. Sterile Specimen
If a patient doesn’t have a catheter, catheter-
ize, clamp the catheter for 30 minutes to allow
urine to collect in the bladder
Using aseptic technique, swab the outside dis-
tal end of the catheter with antiseptic
Insert a sterile needle and syringe and aspirate
the required amount of urine
Empty the collected amount into the specimen
container
4. 24 hour Urine Specimen
Give patient a container to void in
Instruct the patient to collect all urine for 24
hours
Have the patient void when the 24 hour period
is about to begin and discard this urine since it
was formed before the 24 hour period began
Measure, record and keep all the urine voided
for 24 hour period
Instruct patient to void a few minutes before
the end of 24 hours. This ensures that the
bladder is empty before the end of 24 hours
The most appropriate time is 8am – 8am
Label the specimen and send to the lab to-
gether with the request form

Note: Incase the patient is female and is

having her menses, wash the genitalia, plug
the vagina, collect the specimen and unplug
the vagina immediately
 STOOL
It is examined for several reasons:
To determine the presence of infection
To observe for amount, consistency, content
and color
To identify parasites, either ova and cyst of the
parasite
To identify bacteria incase of infection
Characteristics of Stool
Brown in color but may change depending on
diet
Has characteristic odor
Soft and formed
Contents include indigestible food, mucous,
Abnormalities of Stool
Constipation – Hard stool
Diarrhea – Loose watery with increased fre-
quency
Bright red stool– Indicates bleeding in the rec-
tum and lower colon
Dark red (melena) stool – Indicates bleeding in
upper GIT
Black stool – Results from iron supplements
Ricey water stool – Cholera
Pea soup – Typhoid
Ribbon stool – Colon tumor
Abnormalities with content include: Pus; Para-
site; Foreign bodies; Gall stones; Undigested
food e.g. milk, excess fat (Steatorrhea or steat-
Procedure for Stool Specimen Collection
Read physician’s guidelines
Collect all equipment – stool specimen con-
tainer with cover, wooden spatula, toilet paper,
lab request form, gloves, air freshener, label
Identify the patient and explain the procedure
and request patient to defecate into a bed pan
or kidney dish
Transfer a specimen of the stool from bed pan
to specimen container using a spatula
Discard spatula immediately
Discard the remaining stool and decontaminate
the bed pan. Clear the equipment
Remove gloves and wash hands
 VOMITUS COLLECTION
Vomitus is the ejected stomach content by re-
verse peristalsis
It is collected and assessed for Content, color,
smell, amount etc.
It may have food partially digested
If it is clear watery fluid, can indicate morning
sickness
Yellow green and sticky fluid is common in post
– operative patients due to anesthesia
Blood indicates bleeding from GIT: Bright red
indicates bleeding from esophagus, whereas
Dark red/coffee ground indicates bleeding from
stomach and is common in peptic ulcers
 SPUTUM COLLECTION
Collected for the following purpose:
Cytological examination – identify cancerous
cells
To identify pathogens and disease causing mi-
cro – organisms
For culture and sensitivity – to check micro –
organisms especially bacteria and determine
which antibiotic is to be used

Note: Should be collected early in the morning

before the patient takes breakfast. Patient
should be given plenty of fluids the night
before to help in expectoration as it makes