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
