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Nursing ProcedureSTOOL-ROUTINE TEST AND CULTURE

STOOL-ROUTINE TEST AND CULTURE

STOOL-ROUTINE TEST AND CULTURE

Collection of stool specimen for specific or routine tests (stool culture to detect abnormal characteristics)

Purpose

  • To identify specific pathogens
  • To determine presence of blood, ova and parasites
  • To determine presence of fat
  • To do gross examination of stool characteristics such as color, consistency and color

Normal Characteristics of Feces

  • Color: light to dark brown
  • Odor: pungent smell
  • Frequency: 1-2 times per day
  • Quantity: 4-5 ounces per day
  • Composition: 30% water, shed epithelium from the intestine, a considerable quantity of bacteria and a small quantity of nitrogenous matter
  • Stool of infants: at birth, the stool of infants is dark green and it is called “meconium”

Abnormal Characteristics of Feces

Color

  • Tarry black stools – bleeding in the upper gastro-intestinal tract
  • Black color stool – melena, administration of iron or charcoal
  • Clay colored stool – obstruction to the flow of bile
  • White colored stool – presence of barium salts after barium tests

Odor

Melana and dysentery – foul smell

Frequency

  • Diarrhea – increased frequency
  • Constipation – decreased in frequency and low residue diet

Consistency and Form

  • Watery stools – diarrhea
  • Rice water stools – cholera
  • Pea soup stools – typical of typhoid fever

Appearance

  • Fresh blood in large amounts – bleeding piles
  • Blood and mucus stool – amoebic or bacillary dysentery
  • Worm or segments or worms in stool – parasitic cysts, ova or larvae

General Instructions

  • Fecal specimens are collected for chemical bacteriological or parasitological analysis
  • Fecal specimens should be collected in the early stages of disease preferably before antibiotic treatment is given
  • Stool specimens should be collected in a sterile container (making use of the scoop provided in the container) with a tight-fitting leak proof lid
  • After collection, the lid should be immediately replaced tightly
  • After proper labeling, the collected stool should be handed over to the laboratory without delay

Preliminary Assessment

Check

  • The doctors order for any specific instructions
  • General condition and diagnosis of the patient
  • Assess the self-care ability
  • Mental status to follow instructions
  • Articles available in the unit

Preparation of the Patient and Environment

  • Explain the procedure to the patient
  • Provide privacy
  • Arrange the articles at bedside
  • Obtain laboratory request and container

Equipment

  • Appropriate specimen container
  • Spatula (clean for routine, sterile for culture)
  • Bedpan or portable commode
  • Gloves
  • Waste paper

Procedure

  • Instruct patient to defecate into clean dry bedpan or commode
  • Instruct not to contaminate specimen with urine
  • Nurse to wear gloves while collecting specimen
  • Collect stool specimen with clean spatula for routine stool test and with sterile spatula into culture container
  • Cover the container tightly

After Care

  • Remove the gloves
  • Wrap spatula in waste paper and discard appropriately
  • Label specimen container with name, hospital number, and date
  • Send to laboratory immediately (fresh specimen provides more accurate results)
  • Replace equipment and after cleaning
  • Record the procedure in nurse’s record sheet
 STOOL-ROUTINE TEST AND CULTURE -  Purpose,  Normal And Abnormal Characteristics of Feces,  Instructions,  Preliminary Assessment,  Preparation of the Patient and Environment,  Equipment,  Procedure,  After Care
STOOL-ROUTINE TEST AND CULTURE Purpose, Normal And Abnormal Characteristics of Feces, Instructions, Preliminary Assessment, Preparation of the Patient and Environment, Equipment, Procedure, After Care
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