Collection of sputum, urine, feces for laboratory testing

Sputum collection. Sputum is an abnormal respiratory tract that is secreted by coughing. Sputum examination helps to establish the nature of the pathological process in the respiratory organs, and in some cases to determine the causes of its occurrence.

The study should be subjected to as much as possible fresh sputum obtained during morning cough. When there is very little sputum, it is collected for several hours. For special methods of examination, sputum is collected for 1-3 days( as prescribed by the doctor).

The patient should spit the phlegm in the spittoon - a vessel of dark glass with a tightly screwed lid. Before taking sputum for examination, the spittoon should be washed with soap, boiled for 15-20 minutes and cooled. It should not contain foreign impurities, such as food residues, vomit, etc.; it should not be filled with water.

In children who do not know how to cough up phlegm and swallow it, proceed as follows: irritating with a cotton swab, wrapped around a teaspoon handle, the root area of ​​the tongue and the posterior pharyngeal wall, cause a cough reflex;The obtained phlegm is collected with the same tampon and placed in a spittoon bowl. You also have to deal with very weak patients who do not have the strength to cough up phlegm.

The morning sputum collected for the study should be delivered to the laboratory no later than 1-1.5 hours. Conditions must be created that exclude its cooling during transport. Otherwise, sputum will quickly change its qualities, the composition of microbial colonies, which will have the most adverse effect on the results of the study, distorting them.

For the special purpose of the doctor, the entire volume of sputum is sent to the laboratory for the indicated number of days. In this case, patients should be warned about the need to spit into the jar all expectorant sputum, and not swallow it after coughing.

In some cases, the doctor orders that the daily amount of sputum is recorded for a long time. As a rule, after a morning toilet, a sputum volume obtained over the past 24 hours is measured. To do this, sputum sputum is poured into a measuring cup of light clear glass, fix the amount and the result is recorded in a special table of sputum counting. At this time is being produced sputum collection for the following day.

The used spittoons should be washed well with warm water and detergent and boiled for 20 minutes in a 2% solution of soda. Persons caring for the patient, especially with inflammatory diseases of the respiratory system, should ensure that patients do not spit spit on the floor or in the handkerchief, as the microbes in the sputum rise into the air and are inhaled by others, which can lead to the transmission of infection. It should be strictly required that the patient use the spittoon, observe the anti-epidemic regimen. For decontamination of sputum, 5% solution of carbolic acid, 2% solution of potassium permanganate or 3% solution of chloramine is poured onto the bottom of the spittoon bowl.

The appearance of veins or large amounts of blood in the sputum indicates pulmonary hemorrhage, which is a dangerous complication of pulmonary diseases. Having seen this, carers for the patient should immediately inform the district doctor about it or call an ambulance.

Taking urine. Urine is an aqueous and partially colloidal solution of a variety of organic and inorganic substances released by the kidneys. In it, the products of physiological and pathological metabolism, blood cells, cellular structures of the urinary tract and the kidneys themselves, various salts in the form of crystals( sediments), microorganisms and other components can be in a suspended or dissolved state. In the composition of urine, its chemical properties reflect not only the damage of the urinary system itself, but also a number of diseases associated with metabolic disorders, with circulatory disorders, and so on. Therefore, to monitor the condition of the body, the activities of the patient's vital systems, evaluate the effectiveness of treatment activities, it is necessary to monitor the urination regularly and to send urine to the laboratory regularly( as prescribed by the doctor).

The caregiver should keep track of the amount of urine released( normally an adult releases 1.2-1.4 L of urine per day), in color( normal straw-yellow urine).Particular attention should be paid to the admixture of blood in the urine( staining the urine in a pink or reddish color), which may indicate severe damage to the urinary tract, especially if the urine is swallowed by formless clots blood-dark color. It is necessary to monitor the frequency of urination( a normal person urinates 4-6 times a day) and the amount of urine released for each urination.

Special attention should be paid to the presence of pain in the lumbar region, which can often be associated with the development of pathological processes in the kidneys.

All violations related to the activity of the urinary system should be reported to him at the first visit to the doctor. For the direction of urine for the study should be borne in mind the following.

1) Usually, the morning portion of urine is collected, which is the most concentrated, thus providing the most complete picture of its composition.

2) Men get urine directly into a cleanly washed bottle, and for women it is necessary to cook some clean utensils with a wide neck, from which it is then convenient to pour the urine into the bottle.

3) A woman before urination should make the toilet of the genitals, washing them with cotton or gauze moistened with warm water( especially carefully during menstruation), and put a fleece into the vaginal opening so that the discharge from it does not get into the urine.

4) Urine, which is sent for analysis, can not be kept in a warm place for a long time, as long-term storage it quickly decomposes, and best of all, wrapping the bottle with urine in paper, immediately send to the laboratory.

A significant number of patients have to regularly monitor the daily amount of urine( heart patients, kidney patients, patients with diabetes mellitus, etc.) and mark it in a special observation card. In addition, according to the doctor's prescription for urine chemical research, which aims at various quantitative determinations, it is also necessary to take daily urine, since individual portions can give significant fluctuations in their composition. The daily amount of urine is collected as follows: begin to collect urine of the patient after he urinated in the toilet( on the ship), for example at 8 o'clock in the morning. After that, all the urine during the day is collected in a special, immaculately clean and dry 2-3-liter jar with a wide neck and lid. In a day, ie, at 8 am the next day, the patient releases the urine left in the bladder. In order to avoid the development of fermentation and putrefactive processes, the can should be stored in the cold in a closed form.

It is not uncommon for patients to take urine from patients for a number of special catheter studies at home. This procedure should be performed in all cases only by a nurse sent from the polyclinic, using for these purposes a sterile catheter and a sterile stopper.

Taking a stool. Cal( bowel movements) is the contents of the lower intestine, removed during defecation( stool, bowel movement) and consisting mainly of food debris not digested by the body, remnants of digestive juices, cells of the intestinal mucosa and a large number of bacterial bodies( microorganisms) that make upalmost half of the stool mass.

The stool is taken by all patients for the diagnosis of diseases of the digestive system.

Persons caring for patients at home should pay attention to the amount of feces, the frequency of the stool, to inform the doctor of all unfavorable changes in the activity of the intestine. The amount of feces excreted per day in a person without digestive disorders is subject to large fluctuations, depending on the amount and composition of the food taken.

With mixed food, the amount of stool is 100-200 g per day. In addition to the composition of food per day, the amount of feces is affected by the state of the digestive system. The amount of feces increases, first, with

excessively rapid passage of the food mass through the intestine, which prevents sufficient absorption of it;secondly, with a decrease in the absorption capacity of the intestinal wall;third, with increased penetration of fluid into the lumen of the intestine in the inflammatory processes of its mucosa. With severe enteritis( inflammation of the small intestine), the amount of excrement can reach 2500 g. With prolonged constipation, the amount of feces may be prohibitively small due to a greater than normal suction in the intestine.

The frequency of stools under normal conditions does not exceed once a day, and the need for defecation appears usually at the same time of day, most often in the mornings.

Only in rare cases, when it is necessary to determine the number of feces allocated per day, or when it is meant to quantify certain components of the excrement( fat, starch, fiber, protein, etc.), all feces allocated per day are collected. For most studies, a relatively small( 10-15 g) amount of feces is sufficient.

Usually feces for examination are taken in the morning, after sleep. The patient empties the intestine into the pot( vessel).A small amount of stool with a wooden spatula or spatula is put in a clean dry jar with a label, covered with a lid. In this form, the stool is sent to a general study.

To study feces for eggs of worms or the presence of simple amoeba, infusoria, etc.), absolutely fresh feces are required, preserved until delivery to the laboratory in a warm form. In addition to the fact that for the study it is necessary to take stool from three different places of the entire volume of feces, in order to ensure high detection of clapuluses and seeding, the simplest collection of feces for analysis and delivery to the laboratory should be performed repeatedly( at least 2-3 consecutive consecutive days).

For bacteriological examination, bowel movements are sent to a laboratory in a sterile jar or vial. At the same time, a special sterile test tube with a cotton swab, well-screwed onto the wire, is obtained in the bacteriological laboratory the day before. The patient is placed on his right side, his left hand is moved apart by the buttocks, with his right hand, with a rotational movement, the cotton swab is carefully inserted into the anus, and carefully removed and inserted into the tube without touching the edges and wall. When you receive a sterile test tube( jar) in the laboratory with a sterile glass or wooden stick inserted into it( without a tampon), proceed as follows. After defecation of the patient to a clean vessel, take a piece of stool with a mass of no more than 1-2 g from the middle of the stool volume with a sterile stick, gently place the test tubes( jars) on the bottom and tightly cover with sterile cotton wool.

For examination of feces for blood impurities, especially for latent bleeding, the patient is cooked for 3 days, excluding meat and fish products from the diet, as well as medications containing iodine, bromine and iron. On the 4th day they send the feces to the laboratory.

In case of obstinate constipation, when there is no stool alone, to receive the required amount of feces for the study, it is necessary to carry out a colonic massage. If this does not help, you should apply a cleansing enema. For the study, it is necessary to take a dense part of the stool.