Medical assisting Administrative and clinical procedures (5e) Chapter 47 Processing and testing urine and stool samples

CHAPTER

47
Processing and
Testing Urine and
Stool Samples
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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.

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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.

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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

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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
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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
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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.

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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
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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

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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

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47-11

Specimen Types (cont.)
• Random urine specimen
– Most common
– Obtained any time during the day
• First morning specimen
– Collected after a night’s sleep

– Contains greater concentration of substances

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47-12

Specimen Types (cont.)
• Clean-catch midstream
– Used for culturing urine
– External genitalia must be cleansed
– A small amount of urine is discarded prior to
collecting specimen

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47-13

Specimen Types (cont.)
• Timed urine specimen
– Discard first specimen
– Collect all urine for specified time
– Refrigerate
• 24-hour specimen
– Timed collection
– Instruct as for a timed specimen

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47-14

Catheterization
• Procedure by which the catheter is inserted into
the bladder

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47-15

Catheterization (cont.)
• Reasons
– Relieve urinary retention
– Obtain a sterile urine specimen
– Measure the amount of residual urine
– Obtain a specimen if patient cannot void
– Instill chemotherapy
– Empty bladder before and during procedures
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47-16

Catheterization (cont.)
• Drainage catheters
– Indwelling urethral catheter
– Retention catheter
– Ureteral catheter
– Cystostomy tube
– Straight catheter
• Splinting catheter – inserted after repair of ureter

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47-17

Catheterization (cont.)
• Not a routine procedure due to risk of infection
• Not typically performed by medical assistants
– Check scope of practice
– Assemble supplies

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47-18

Special Considerations
• Male and female patients
– Differences in collecting clean-catch

midstream specimen
– Questions during history
• Pregnant patients
– Frequency
– Prone to urinary tract infection
– Urine checked for glucose and protein

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47-19

Establishing Chain of Custody
• Do not alter the procedure
• Explain procedure
• Consent form gives permission to
– Collect the specimen
– Prepare it for transport to laboratory
– Release the results to agency requesting test

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47-20

Preservation and Storage
• Changes can occur if urine is left at room
temperature for more than 1 hour

• Preservation
– Refrigeration

Specimens
only

• Prevents growth for 24 hours
• Return to room temperature
before testing

– Chemical preservatives

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47-21

Apply Your Knowledge
True or False:
ANSWER:
T A random urine specimen can be collected any time.

F A clean-catch midstream urine specimen should be
collected the first thing in the morning.

first morning

T Instruct the patient to discard the first specimen when
collecting a timed or 24-hour specimen.

T A chain of custody form gives you permission to release
F the results to the agency requesting the test.

Urine specimens should be refrigerated if they will not
be tested within one
four hours.
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47-22

Urinalysis
• Evaluation of urine to obtain information about
body health and disease
• Types of testing
– Physical
– Chemical
– Microscopic

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47-23

Urinalysis (cont.)
• Values
– Negative or none, normal, or a range of

concentration
– Within normal limits indicate health and
normality
• Screening – must have follow-up testing

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47-24

Urinalysis (cont.)
• Average adult daily urine output is 1250 mL/24
hours
• Intake and output should be approximately the
same
• Dysfunctions of other body systems can affect
urinary function

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47-25

Physical Examination and Testing of Urine
Specimens
• Check label
• Check for visible
contamination

• Check time since
collection

• Visual examination
– Color and turbidity
– Volume
– Odor
– Specific gravity

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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.