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Chapter 46
Specimen Collection and Processing
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Urine Specimen
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First morning
Midstream clean-catch
24-hour
Pediatric collection
Urinary catheterization
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Chain of Custody
• Collection of urine specimen for substance
abuse analysis
• Detects the presence of illegal drugs and
chemical substances
• Chain of custody forms must be filled out and
procedure followed
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Pregnancy Testing
• Measures the amount of human chorionic
gonadotropin (hCG) in urine or blood
• Most commonly performed on urine at home
and in the POL
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Urinalysis
• Three components
– Physical
– Chemical
– Microscopic
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Physical Urinalysis
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Color
Clarity
Volume
Odor
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Chemical Urinalysis
• Analyze specimen as soon as possible after
collection
• Reagent strips provide qualitative and
quantitative assessments
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Chemical Urinalysis
• Strips are compared to known values on the
bottle for reporting
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Normal and Abnormal Values
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pH
Protein
Ketone
Bilirubin
Urobilinogen
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Hematuria
Nitrite
Leukocyte esterase
Glucose
Specific gravity
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Microscopic Examination
• MAs may prepare the slide for the provider to
view and report results
– Centrifuge urine tubes
– Pour off supernatant
– Collect sediment and place on slide
• The MA does not read or interpret results of
microscopic urine specimen
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Fecal Specimen
• Used to check for occult blood, ova and
parasites, bacterial and viral infections
• Stool specimen are difficult for patients to
collect properly
• Instruct patients to obtain specimen at home
and bring to lab for testing
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Fecal Specimen
• Occult blood specimen
– Common screening tools for early detection of
colon cancer
– Test uses a guaiac reagent
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Bacterial Specimen
• Bacteria, viruses, and fungi are extracted from
specimen for identification, to determine the
appropriate treatment
• Culture is taken from the part of the body that
is infected
– Collected in a culturette
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Bacterial Specimen
• Culture sites
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Throat
Mouth
Ear
Eye
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Nose
Vagina
Anus
Infected Wounds
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Throat Culture
• Taken from patients complaining of sore
throat, fever, swollen glands, and cough
• Rapid Group A strep kits provide results in
minutes
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Blood Cultures
• Blood is drawn from patient directly into a
particular formulated broth in a vacuum bottle
• When a blood culture is positive, this indicates
a systemic infection and requires immediate
attention
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Culture and Sensitivity
• Specimen is collected and inoculated in
special media (agar) to encourage growth of
microorganisms
• Sensitivity tests the organism against different
types of antibiotics
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Culture and Sensitivity
• Media comes in petri dishes, tubes, and
broths
– Primary media encourages the growth of all
microorganisms
– Selective media discourages the growth of certain
microorganisms
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Gram Staining and
Microbiologic Smears
• Used to help identify a bacterial specimen
• Bacteria specimen are sorted into two groups
– Gram positive
• Dark blue to violet after staining
– Gram negative
• Red or pink after staining
• More dangerous connotation than Gram positive
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Morphologic Shapes
• Three basic shapes
– Coccus
– Bacillus
– Spiral
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Morphologic Shapes
• Gram positive cocci in clusters
– Staphylocci
• Gram positive cocci in chains
– Streptococci
• Gram negative cocci in pairs
– Neiserria gonorroeae
• Gram negative bacilli
– Escherichia coli
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