Fundamentals of Nursing Q 41
Which is the correct procedure for collecting a sputum specimen for culture and sensitivity testing?
A. Have the patient place the specimen in a container and enclose the container in a plastic bag.
B. Have the patient expectorate the sputum while the nurse holds the container.
C. Have the patient expectorate the sputum into a sterile container.
D. Offer the patient an antiseptic mouthwash just before he expectorate the sputum.
Correct Answer: C. Have the patient expectorate the sputum into a sterile container
Placing the specimen in a sterile container ensures that it will not become contaminated. A sputum specimen is obtained for culture to identify the microorganism responsible for lung infections; identify cancer cells shed by lung tumors; or aid in the diagnosis and management of occupational lung diseases. The other answers are incorrect because they do not mention sterility and because antiseptic mouthwash could destroy the organism to be cultured (before sputum collection, the patient may use only tap water for nursing the mouth).
Option A: Using the sterile collection container provided, instruct the patient to take three deep breaths, then force a deep cough and expectorate into a sterile screw-top container. To prevent contamination by particles in the air, keep the container closed until the patient is ready to spit into it.
Option B: Ten to 15 ml of sputum is typically needed for laboratory analysis. A specimen will be rejected by the laboratory if it contains excessive numbers of epithelial cells from the mouth or throat or if it fails to show adequate numbers of neutrophils on gram staining. If the patient cannot cough up a specimen, the respiratory therapist can use sputum induction techniques such as heated aerosol (nebulization), followed in some instances by postural drainage and percussion.
Option D: Don’t allow the patient to brush his teeth or use mouthwash. Doing so could kill bacteria in the sputum, rendering it useless. For best results, obtain the sample first thing in the morning. If it can’t be obtained before the patient has breakfast, though, wait at least an hour after he’s eaten before trying. Before beginning, describe the procedure to him.