🩸 “Right technique, right tube, right result – safe blood collection begins with nursing precision.”
🗨️ Blood specimen collection refers to the procedure of withdrawing blood from a vein (venipuncture), artery (arterial puncture), or capillary (finger prick/heel prick) for diagnostic, therapeutic, or monitoring purposes.
✔️ To aid in diagnosis of diseases
✔️ To monitor treatment effectiveness
✔️ For blood typing, cross-matching
✔️ For screening tests, such as glucose, Hb, CBC
✔️ For culture and sensitivity in suspected infections
| 🔢 Type | 📖 Method | 💡 Use |
|---|---|---|
| 💉 Venous Blood | Drawn from a vein (usually antecubital) | Most lab tests (CBC, glucose, liver function) |
| 🩸 Capillary Blood | Fingerstick (adult) / heel prick (neonates) | Glucose monitoring, point-of-care testing |
| 💓 Arterial Blood | From radial/femoral artery | ABG (Arterial Blood Gas) analysis |
✅ Sterile syringe or vacutainer
✅ Needle (18–22 gauge)
✅ Tourniquet
✅ Spirit swabs or antiseptic wipes
✅ Blood collection tubes (color-coded)
✅ Cotton balls & adhesive tape
✅ Gloves & PPE
✅ Biohazard waste bag
✅ Requisition form and patient label
| 🎨 Tube Color | 💉 Additive | 🔍 Common Tests |
|---|---|---|
| 🟤 Yellow | Clot activator | Serology, chemistry |
| 🟥 Red | No additive (plain) | Blood bank, drug levels |
| 💛 Gold | Gel separator | Electrolytes, liver/kidney function |
| 💜 Purple | EDTA | CBC, ESR, HbA1c |
| 💚 Green | Heparin | ABG, ammonia |
| 🩵 Light Blue | Sodium citrate | Coagulation tests (PT, aPTT) |
| 🩸 Gray | Fluoride oxalate | Blood sugar, lactate |
🧠 Order of draw is crucial to prevent contamination (SST → EDTA → Citrate → Fluoride)
1️⃣ Explain procedure to patient and take consent
2️⃣ Assemble all articles & wear gloves
3️⃣ Position patient comfortably; apply tourniquet 3–4 inches above site
4️⃣ Select vein (median cubital preferred); cleanse area with 70% alcohol
5️⃣ Let it air dry
6️⃣ Insert needle bevel up, at 15–30° angle
7️⃣ Collect appropriate amount of blood into labeled tubes
8️⃣ Release tourniquet before removing needle
9️⃣ Apply pressure with cotton ball, secure with tape
🔟 Label sample & send to lab immediately
🔸 Do not draw from edematous or sclerosed veins
🔸 Avoid prolonged tourniquet time (>1 min)
🔸 Use correct tube and invert gently (do not shake)
🔸 Label sample in front of the patient
🔸 Maintain aseptic technique throughout
🔸 Use PPE and dispose sharps properly
🔹 Confirm patient identity (name, age, ID)
🔹 Educate & reassure patient
🔹 Select correct site & tube
🔹 Maintain asepsis and follow standard precautions
🔹 Ensure sample reaches lab without delay or clotting
🔹 Record time, date, and site of collection
🔹 Report any adverse reactions (fainting, hematoma)
✅ Q: Which vein is most commonly used for venipuncture?
🅰️ Median cubital vein
✅ Q: Which tube is used for CBC testing?
🅰️ Purple (EDTA)
✅ Q: What is the order of draw to prevent contamination?
🅰️ Citrate → Plain → SST → Heparin → EDTA → Fluoride
✅ Q: What is the function of sodium fluoride in gray top tube?
🅰️ Prevents glycolysis (preserves glucose)
✅ Q: What should a nurse do before inserting the needle?
🅰️ Clean the site and allow it to air dry
💧 “Right sample, right method — accurate diagnosis starts here.”
🗨️ Urine specimen collection refers to the process of collecting a urine sample from a patient for the purpose of laboratory examination, including physical, chemical, and microscopic analysis.
✅ It is one of the most common non-invasive diagnostic tests used in healthcare.
✔️ Diagnose urinary tract infections (UTIs)
✔️ Assess kidney function (urea, creatinine, protein)
✔️ Detect glucose, ketones (diabetes screening)
✔️ Monitor drug levels or pregnancy
✔️ Conduct culture & sensitivity tests
| 🔢 Type | 📖 Description | 💡 Purpose |
|---|---|---|
| 🚽 Random Sample | Collected at any time of day | Routine urinalysis |
| 🕗 First Morning Sample | First voided sample after waking | Ideal for pregnancy test, concentrated urine |
| 🧼 Clean Catch Midstream (CCMS) | Middle portion after initial stream | Urine Culture & Sensitivity |
| ⏳ Timed Collection (e.g., 24 hr) | Collected over a specific time period | Creatinine clearance, protein estimation |
| 🧪 Catheter Specimen | Collected via sterile technique from Foley catheter | Culture in catheterized patients |
| 👶 Pediatric Bag Collection | Collected using a sterile urine bag | Non-invasive method for infants |
✔️ Sterile/clean urine container
✔️ Antiseptic swabs
✔️ Gloves & PPE
✔️ Labelling materials (name, ID, date, time)
✔️ Requisition form
✔️ Patient education card (for 24 hr collection)
✔️ Ice box (for 24-hour urine storage)
1️⃣ Explain procedure and get consent
2️⃣ Perform hand hygiene and wear gloves
3️⃣ Instruct patient to clean genital area with antiseptic wipes
4️⃣ Start urinating, then collect midstream urine into sterile container
5️⃣ Secure lid tightly and label correctly
6️⃣ Send sample to lab within 30–60 minutes
🔹 Discard first morning void (Day 1, 7 AM)
🔹 Collect all urine for the next 24 hours
🔹 Store in a cool place or ice box
🔹 Collect last urine (Day 2, 7 AM)
🔹 Label and send entire container to lab
🔸 Use sterile container for culture tests
🔸 Avoid contamination with feces or toilet paper
🔸 Female patients: avoid during menstruation (or inform lab)
🔸 Pediatric: secure urine bag properly to avoid leakage
🔸 Delay in transport may cause bacterial overgrowth
🔹 Instruct patient on proper collection technique
🔹 Label container with correct patient details
🔹 Wear PPE and handle urine as potentially infectious
🔹 Ensure timely transport to lab
🔹 Document time, date, and type of specimen
✅ Q: Which urine sample is best for culture and sensitivity test?
🅰️ Clean Catch Midstream (CCMS)
✅ Q: What is the first step in 24-hour urine collection?
🅰️ Discard the first morning void
✅ Q: What should be done if the urine sample cannot be sent immediately?
🅰️ Refrigerate or store in cool environment
✅ Q: Which urine specimen is ideal for pregnancy testing?
🅰️ First morning urine
✅ Q: What is the nurse’s role after collecting urine?
🅰️ Label, document, and send the sample promptly to the lab
💩 “The sample might be gross—but it reveals a lot!”
🗨️ Stool specimen collection is the procedure of obtaining a fecal sample from a patient for laboratory analysis to help diagnose gastrointestinal, parasitic, or infectious conditions.
✅ It is a non-invasive and essential diagnostic tool.
✔️ Detect parasitic infections (e.g., amoebiasis, giardiasis)
✔️ Identify bacterial or viral causes of diarrhea (e.g., salmonella)
✔️ Detect occult (hidden) blood in stools
✔️ Diagnose digestive disorders (e.g., malabsorption, IBD)
✔️ Screen for colorectal cancer
✔️ Observe consistency, color, and presence of mucus, pus, or worms
| 🧾 Test Type | 🧪 Purpose |
|---|---|
| 🔬 Routine Microscopy | Check ova, parasites, cysts, RBCs, pus |
| 🧫 Culture & Sensitivity (C/S) | Identify pathogens (e.g., Shigella, Salmonella) |
| 💉 Occult Blood Test (FOBT) | Detect hidden blood in stool |
| 🧪 Fat Analysis | Evaluate steatorrhea (fatty stool) |
| 🧬 DNA Tests | Detect genetic markers or cancer cells |
✔️ Clean, dry, wide-mouthed container with lid (for routine test)
✔️ Sterile container (for culture & sensitivity)
✔️ Gloves, apron, mask
✔️ Disposable spatula or spoon
✔️ Lab request form
✔️ Bedpan/commode (if patient is bedridden)
✔️ Labeling stickers
1️⃣ Explain procedure to the patient
2️⃣ Perform hand hygiene and wear gloves
3️⃣ Provide patient with clean collection container
4️⃣ Instruct to pass stool directly into the container (no mixing with urine or water)
5️⃣ Using a spatula, transfer a small amount (approx. walnut size) into specimen jar
6️⃣ Secure the lid tightly and label with name, date, and time
7️⃣ Send to the lab within 30 minutes (or refrigerate for max 2 hrs if delayed)
8️⃣ Remove gloves, perform hand hygiene, document the collection
🔸 Do not collect from toilet bowl
🔸 Avoid contamination with urine, water, or toilet paper
🔸 For infants, line diaper with plastic wrap
🔸 Early morning sample is preferred for parasites
🔸 In case of suspected worms, visible worms should be collected
🔹 Provide clear instructions to patient or family
🔹 Use appropriate container for test type (sterile vs non-sterile)
🔹 Wear PPE and handle stool sample with caution
🔹 Ensure sample reaches lab within proper timeframe
🔹 Maintain documentation and chain of custody if needed
✅ Q: What type of container is used for stool culture?
🅰️ Sterile container
✅ Q: Why should urine be avoided in stool samples?
🅰️ It contaminates the sample and affects test accuracy
✅ Q: What is the best time to collect stool for parasite detection?
🅰️ Early morning
✅ Q: What is the nurse’s first step in stool collection?
🅰️ Explain the procedure to the patient
✅ Q: How long can stool sample be stored before testing?
🅰️ Ideally tested within 30 minutes; refrigerate if delayed (max 2 hrs)
🫁 “A deep cough today leads to a clear diagnosis tomorrow!”
🗨️ Sputum collection is the process of obtaining mucus or phlegm from the lower respiratory tract (lungs, bronchi) to be examined in a laboratory for diagnostic purposes.
✅ NOT saliva — sputum must come from deep within the chest.
✔️ Diagnose respiratory infections (e.g., TB, pneumonia)
✔️ Detect Mycobacterium tuberculosis (AFB test)
✔️ Perform Culture & Sensitivity (C/S) for antibiotics
✔️ Identify malignant cells (cytology for lung cancer)
✔️ Detect fungal or parasitic infections
| 🔢 Test Type | 🧬 Purpose |
|---|---|
| 🔬 Routine Microscopy | Check for pus cells, epithelial cells, bacteria |
| 🧫 Culture & Sensitivity (C/S) | Identify specific pathogens and their drug response |
| 🧪 AFB Test (Ziehl-Neelsen stain) | Detect acid-fast bacilli (e.g., TB) |
| 🧬 Cytology | Detect abnormal or cancerous cells |
| 🦠 GeneXpert / CB-NAAT | Rapid test for TB with rifampicin resistance |
✔️ Sterile wide-mouthed screw-cap sputum container
✔️ PPE (mask, gloves, gown)
✔️ Drinking water (optional to rinse mouth)
✔️ Labelling materials
✔️ Requisition form
✔️ Plastic bag (for transport)
1️⃣ Explain the procedure clearly to the patient
2️⃣ Perform hand hygiene and wear PPE
3️⃣ Instruct patient to rinse mouth (not gargle) with plain water
4️⃣ Ask patient to take deep breaths and cough deeply from the chest
5️⃣ Collect early morning sample (best quality) before food or brushing
6️⃣ Ensure at least 5–10 mL of sputum (not saliva) is collected
7️⃣ Seal the container, label with patient details
8️⃣ Send to lab within 1 hour or refrigerate if delayed
9️⃣ Remove gloves, perform hand hygiene, document the sample
🔹 Sputum must be from deep chest, not saliva
🔹 Collect sample in open-air area or well-ventilated room
🔹 Preferably collect 3 consecutive early morning samples for TB
🔹 Close container immediately after expectoration
🔹 Avoid eating, drinking, or brushing teeth before collection
🔸 For patients unable to expectorate — nebulization with saline may be used
🔸 For children — gastric aspiration may be done for TB
🔸 For very ill patients — suctioning by sterile catheter may be necessary
🔹 Educate patient on proper sputum production
🔹 Use correct sterile container
🔹 Ensure proper PPE usage & infection control
🔹 Label and transport sample without delay
🔹 Record time, date, and type of test requested
🔹 Report abnormal findings or patient difficulty
✅ Q: What is the best time to collect sputum?
🅰️ Early morning before eating or brushing
✅ Q: What test is used to detect tuberculosis in sputum?
🅰️ AFB (Acid-Fast Bacilli) stain or GeneXpert
✅ Q: What is the ideal amount of sputum required for lab test?
🅰️ 5–10 mL
✅ Q: Which specimen is unacceptable for sputum culture?
🅰️ Saliva
✅ Q: What should a nurse instruct the patient before sputum collection?
🅰️ Rinse mouth and cough deeply from lungs
🧫 “Let it grow to know — culture reveals the unseen enemy.”
🗨️ A Culture Test is a diagnostic laboratory test that involves growing microorganisms (bacteria, fungi, viruses) from clinical specimens in controlled conditions to identify infectious agents.
✅ It helps in selecting appropriate antibiotics by performing sensitivity testing.
✔️ Identify causative organism of an infection
✔️ Guide appropriate antibiotic therapy
✔️ Monitor treatment effectiveness
✔️ Detect carrier states (e.g., typhoid, MRSA)
✔️ Confirm or rule out infections in sterile body sites
| 🔬 Test | 🧍 Specimen Source | 💡 Used For |
|---|---|---|
| 💉 Blood Culture | Venous blood | Septicemia, endocarditis |
| 💧 Urine Culture | Midstream/24-hour urine | UTI, cystitis |
| 🫁 Sputum Culture | Morning sputum | TB, pneumonia, bronchitis |
| 🧠 CSF Culture | Lumbar puncture | Meningitis |
| 👃 Throat/Nasal Swab Culture | Posterior pharynx/nasal cavity | Pharyngitis, diphtheria |
| 🧫 Stool Culture | Fresh stool | Salmonella, Shigella |
| 🦵 Wound Swab Culture | Open wounds, abscess | MRSA, Pseudomonas |
| 👶 Vaginal/Cervical Swab | Female genital tract | STIs (gonorrhea, candida) |
✔️ Sterile swab sticks or culture bottles
✔️ Appropriate sterile containers
✔️ PPE (gloves, mask, apron)
✔️ Labels & lab request forms
✔️ Alcohol swab / antiseptic solution
✔️ Blood collection set (for blood culture)
✔️ Ice box or transport medium (if needed)
1️⃣ Explain procedure and take informed consent
2️⃣ Perform hand hygiene and wear PPE
3️⃣ Collect specimen using aseptic technique
4️⃣ Use appropriate sterile containers/media
5️⃣ Label specimen with name, ID, date, and time
6️⃣ Send to lab immediately (within 30 minutes preferred)
7️⃣ Record time, type of specimen, and appearance
8️⃣ Wait for lab results (usually 24–72 hours)
🔹 Use aseptic technique while collecting samples
🔹 Ensure timely and correct labeling
🔹 Avoid contamination (e.g., urine mixed with vaginal secretions)
🔹 Educate patients on proper sample collection
🔹 Transport specimen promptly
🔹 Monitor results and notify physicians
✅ Q: What is the purpose of a culture test?
🅰️ To identify the microorganism causing an infection
✅ Q: Which sample requires a sterile swab stick?
🅰️ Throat or wound swab
✅ Q: What does sensitivity in a culture report indicate?
🅰️ Which antibiotic is effective against the microbe
✅ Q: What is the best time to collect sputum for culture?
🅰️ Early morning before brushing
✅ Q: What is the ideal time frame to send culture samples to lab?
🅰️ Within 30 minutes
🧠 “When the brain speaks through fluid — listen carefully with care.”
🗨️ CSF (Cerebrospinal Fluid) is a clear, colorless fluid found in the brain and spinal cord that cushions and protects the CNS.
✅ CSF sample collection is the withdrawal of fluid via lumbar puncture (LP) for diagnostic or therapeutic purposes.
✔️ Diagnose meningitis, encephalitis, TB, syphilis
✔️ Detect subarachnoid hemorrhage (SAH)
✔️ Measure intracranial pressure
✔️ Diagnose multiple sclerosis (MS)
✔️ Rule out malignancies or metastases
✔️ Administer intrathecal drugs (chemo, antibiotics)
| 🔢 Test Type | 🧪 Purpose |
|---|---|
| 🔍 Physical Exam | Color, clarity, pressure |
| 🧫 Microscopy | Cell count, WBC, RBC |
| 🎨 Biochemistry | Glucose, protein, chloride |
| 🧪 Culture & Sensitivity | Identify causative organism |
| 🧬 Serology / PCR | TB, viral meningitis, cryptococcus |
| 🧠 Cytology | Detect abnormal or cancer cells |
✔️ Sterile lumbar puncture tray
✔️ Spinal needle (18–22 G with stylet)
✔️ 3–4 sterile CSF collection vials
✔️ Antiseptic solution (povidone-iodine)
✔️ Sterile gloves, gown, mask
✔️ Local anesthetic (e.g., lidocaine)
✔️ Drapes & bandages
✔️ Requisition form & patient ID label
1️⃣ Explain the procedure and obtain written consent
2️⃣ Ensure NPO status if required
3️⃣ Position patient in lateral decubitus or sitting position
4️⃣ Identify puncture site (between L3–L4 or L4–L5)
5️⃣ Clean and drape sterile field
6️⃣ Inject local anesthesia
7️⃣ Insert spinal needle with stylet until CSF flows
8️⃣ Collect CSF into 4 labeled vials (1–2 mL each)
9️⃣ Withdraw needle and apply dressing
🔟 Send samples immediately to lab
| 🧪 Vial # | 🔍 Test Type |
|---|---|
| 1️⃣ Vial 1 | Biochemistry (glucose, protein) |
| 2️⃣ Vial 2 | Microbiology (Culture, Gram stain) |
| 3️⃣ Vial 3 | Cell count & differential |
| 4️⃣ Vial 4 | Optional: PCR, cytology, special tests |
👩⚕️ Before Procedure:
🔹 Explain and reassure patient
🔹 Check for bleeding disorders / anticoagulants
🔹 Assist in positioning
🔹 Prepare all sterile items
🔹 Ensure informed consent
👩⚕️ During Procedure:
🔹 Assist doctor and monitor vitals
🔹 Maintain asepsis
🔹 Label each vial accurately
👩⚕️ After Procedure:
🔹 Keep patient in supine position for 1–2 hrs
🔹 Monitor for headache, hypotension, numbness
🔹 Encourage fluid intake unless contraindicated
🔹 Document time, amount, color of CSF, patient response
❌ Post-lumbar puncture headache
❌ Infection (meningitis, abscess)
❌ Hematoma or bleeding
❌ Brainstem herniation (increased ICP — contraindicated!)
❌ Back pain or nerve damage (rare)
✅ Q: What is the most common site for lumbar puncture?
🅰️ L3–L4 or L4–L5 interspace
✅ Q: What is the first step before collecting a CSF sample?
🅰️ Explain the procedure and obtain informed consent
✅ Q: Which CSF vial is used for culture?
🅰️ Vial 2
✅ Q: What is a major complication after lumbar puncture?
🅰️ Post-dural puncture headache
✅ Q: When should you NOT perform LP?
🅰️ Increased intracranial pressure (risk of herniation)