SPUTUM CULTURE – (Purposes, General Instructions, Client Preparation, Equipment, Procedure, Documentation)
Sputum culture are obtained to aid with diagnosis and treatment decisions in patients with suspected pneumonia tuberculosis, or there infectious diseases of the lower airway. A microbiology laboratory cultures and incubates the specimen to identify any pathogenic microorganisms. Sputum is obtained for cytology to search for abnormal cells that might indicate cancer or a precancerous condition of the lungs or airway. In either case, it is important to obtain a specimen that has been coughed up and expectorated from the lower airways, with minimal contamination by oral and pharyngeal secretions. The patient must be asked to cough deeply and the specimen is collected in a sterile container
PURPOSE
- Sputum collection for suspected cancer for tuberculosis may be required for three consecutive mornings
- To provide a specimen to determine the presence and type of microorganisms in the oropharynx
GENERAL INSTRUCTIONS
- The specimens should be brought to the office as soon as possible to avoid deterioration of the material
- Most diagnostic specimens are obtained early in the morning when the greatest volume of secretions has had a chance to accumulate
- If the sputum specimen is not possible to collect, specimen may also be collected after respiratory treatments or therapy
- It is vitally important that the patient understand that the specimen must be collected from the lung field and not from the mouth
- Pathogen must be collected from sits of concern with a twisting motion for maximum collection. Touching other areas will alter the substances on the swab
CLIENT PREPARATION
- Inform about the difference between saliva and sputum may need to be explained on the client’s level of understanding
- Before the sputum collection, encourage the client to increase fluid intake to decrease the viscosity (thickness) of the secretions
- The client may be weak from illness, and thick mucus will be hard to bring up, causing the client to be even more exhausted. A cool mist humidifier may help also
EQUIPMENT
- Tongue blade (depressor)
- Sterile specimen container
- Sterile swab (if one is not supplied with the specimen container)
- Complete laboratory request slip
PROCEDURE
- Wash hands
- Arrange the equipment and supply
- Explain the procedure to the client
- Put the gloves and face mask or shield
- Carefully remove the sterile swab from the container
- Have the patient say AHHH as you press on the midpoint of the tongue depressor
- Swab the area of concern on the mucous membranes, especially the tonsillar area, the crypts, and anterior and posterior pharynx. Turn the swab to expose all its surfaces. Avoid touching areas other than those suspected of infection
- Maintain the tongue depressor position while withdrawing the swab
- Follow the instructions on the specimen container for transferring the swab. Some require that the wooden swab stick to broken after dropping into the culture; others may have a special swab that is contaminated within the container and is secured when the container is sealed
- Properly dispose of the equipment and supplies, remove gloves and wash your hands
- Route the specimen or store it appropriately until routing can be completed
DOCUMENTATION
- Date and time
- Collection of throat culture
- Routing of specimen
- Patient complaints/concerns
- Patient education/instructions
- Signature and name of the nurse
