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After completing this unit, you should be able to: Discuss the role of the medical assistant in collecting, processing, and testing urine and stool samples; carry out procedures for following guidelines when collecting urine specimens; describe the process of urinalysis and its purpose;...
CHAPTER 47 Processing and Testing Urine and Stool Samples © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-2 Learning Outcomes 47.1 Discuss the role of the medical assistant in collecting, processing, and testing urine and stool samples 47.2 Carry out procedures for following guidelines when collecting urine specimens © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-3 Learning Outcomes 47.3 Describe the process of urinalysis and its purpose 47.4 Carry out the proper procedure for collecting and processing a stool sample for fecal occult blood testing © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-4 Introduction • Proper collection of urine and stool specimens key to diagnosing • Medical assistant – Learn about urine and fecal specimens – Instruct or assist patient in collection of a specimen – Constituents of urine samples – Chain of custody for drug screening © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-5 The Role of the Medical Assistant • Collect, process, and test urine samples • Knowledge necessary – Anatomy and physiology of kidneys – How urine is formed – Normal components of urine © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-6 Role of the Medical Assistant • Potentially hazardous waste – Standard Precautions – PPE as needed – Handle and dispose of specimens properly – Dispose of used supplies and equipment properly – Sanitize, disinfect, and/or sterilize reusable equipment © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-7 Apply Your Knowledge What does the medical assistant need to know related to collecting, processing, and testing urine specimens? ANSWER: The medical assistant needs to know the anatomy and physiology of the urinary system, how urine is formed, and normal components of urine © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-8 Obtaining Urine Specimens • General guidelines – Follow procedure for specified test – Use appropriate specimen container – Label specimen container correctly – Explain the procedure to patient – Wash your hands before and after; wear gloves – Complete paperwork © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-9 Obtaining Urine Specimens (cont.) • Instruct patients – Test-specific – General • Use correct container • Do not discard preservative • Refrigerate the collection container • Keep lid on the container © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-10 Specimen Types • Quantitative analysis • Qualitative analysis • Vary in – The method used to collect a specimen – The time frame in which to collect a specimen • Follow procedure exactly © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-39 Microscopic Examination of Urine Specimens (cont.) • Cells – Epithelial cells • Renal • Transitional • Squamous – White blood cells – Red blood cells © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-40 Microscopic Examination of Urine Specimens (cont.) • Casts – Cylindrical elements – Protein – Classification • Hyaline • • • • • Granular RBC casts WBC casts Epithelial cell casts Waxy © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-41 Microscopic Examination of Urine Specimens (cont.) • Crystals – Naturally produced solids of definite form – Common in urine – Determine pH before identifying © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-42 Microscopic Examination of Urine Specimens (cont.) • Yeast cells • Bacteria – May be confused with RBCs – Associated with genitourinary tract infection, diabetes – A few are normal – Infection if odor and WBCs are present • Parasites – may indicate infection © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-43 Apply Your Knowledge What is the specific gravity shown on this refractometer screen? ANSWER: The specific gravity shown here is 1.030 © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-44 Apply Your Knowledge Matching: ANSWER: A Casts C pale yellow to dark amber F cloudiness B Specific gravity I absence of urine B measure of concentration of urine H acidity or alkalinity of urine D Renal epithelial cells G genetically inherited disorder D may indicate tubular damage F Turbidity C Normal color E Crystals G PKU A cylinder-shaped sediment of proteins H pH E naturally produced solids in cool urine I Anuria © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-45 Collecting and Processing Stool Specimens • Screening for colorectal cancer – Fecal occult blood test • Tests for hidden blood • Foods and medication may cause false-positives • Patient instruction important © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-46 Collecting and Processing Stool Specimens (cont.) • Suspected Bacterial Infection – Shigella or Salmonella – Loose, bloody or mucus-tinged stools – Culture media • Promote growth of intestinal pathogen • Suppress growth of other microorganisms © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-47 Collecting and Processing Stool Specimens (cont.) • Suspected Protozoal or Parasitic Infection – O & P specimen – Three separate sets of fresh and preserved specimens – Special kits available © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-48 Apply Your Knowledge Besides how to collect the stool sample for FOBT testing, what else you need to tell the patient? ANSWER: The patient need to know to follow all pretest dietary and medication instructions © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-49 In Summary 47.1 Your role as a medical assistant includes collecting, processing, and testing urine samples, and processing and testing stool samples You will also be responsible for teaching patients proper collection methods for urine and stool samples © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-50 In Summary (cont.) 47.2 The general guidelines for collecting a urine specimen include: – following the procedure specified for the urine test that will be performed; – using the type of specimen container indicated by the laboratory; – properly labeling the specimen container; – explaining the procedure to the patient when assisting in the collection process; – washing your hands before and after the procedure and wearing gloves during the procedure; and – complete all necessary paperwork © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-51 In Summary (cont.) 47.3 Urinalysis is the evaluation of urine by various types of testing methods to obtain information about body health and disease © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-52 In Summary (cont.) 47.4 The general guidelines for collecting a stool specimen include: – instructing the patient about the need to follow all collection procedures including when to collect, how to collect, and how to return the specimen to the office; – following the testing procedure for fecal occult blood testing, using Standard Precautions when performing the test; and – documenting the test and results in the patient’s chart © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part 47-53 End of Chapter 47 A human being: an ingenious assembly of portable plumbing ~ Christopher Morley, 1890-1957 © 2014 by McGraw-Hill Education This is proprietary material solely for authorized instructor use Not authorized for sale or distribution in any manner This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part .. .47- 2 Learning Outcomes 47. 1 Discuss the role of the medical assistant in collecting, processing, and testing urine and stool samples 47. 2 Carry out procedures for following... part 47- 3 Learning Outcomes 47. 3 Describe the process of urinalysis and its purpose 47. 4 Carry out the proper procedure for collecting and processing a stool sample for fecal occult blood testing. .. part 47- 5 The Role of the Medical Assistant • Collect, process, and test urine samples • Knowledge necessary – Anatomy and physiology of kidneys – How urine is formed – Normal components of urine