4-7. COLLECTING SPUTUM
a. General. Sputum is mucus from the lung. A sputum specimen must come from deep in the bronchial tree. Expectoration from throat and mouth secretions cannot be used as a sputum specimen. Early morning is the best time to collect a sputum specimen because the patient has not yet cleared the respiratory passages. Many tests can be performed on sputum, such as a culture and sensitivity, cytological examination, and test for acid-fast bacillus. Some patients cannot expectorate a specimen and must have a pharyngeal suctioning to obtain sputum. Closed-method collection containers protect you from contamination from body fluids. The medical specialist explains the procedure and prepares the patient for the test.
b. Important Points.
(1) Oral hygiene should be provided after the procedure for patient comfort.
(2) Accuracy of test decreases if delivery of specimen to laboratory is delayed.
(3) Make certain the patient knows how to perform sputum collection.
(4) The nurse must be prepared to obtain the specimen by suctioning if the patient cannot cough.
(1) Read physician's orders.
(2) Collect supplies.
(3) Introduce yourself.
(4) Identify the patient by identification band.
(5) Explain procedure to patient.
(6) Wash hands and don gloves.
(7) Position patient in Fowler's position.
(8) Instruct patient to take three breaths and force cough into sterile container.
(9) Attach laboratory requisition.