Chapter 28
Respiratory Care
577
Skill 28.1 (continued)
For Obtaining a Sputum Specimen by Coughing and Expectoration
3. After obtaining the specimen, remove the suction tub- ing from the connection and attach the rubber tubing on the specimen trap to the port where the suction tubing was attached. 4. Follow the Ending Implementation Steps located on the inside back cover. Evaluation Steps 1. Ensure that you have at least 30 mL of sputum in the container. 2. Determine the patient’s response to the procedure. 3. Ensure that the specimen is labeled and placed in the appropriate biohazard specimen bag with the requisition. 4. Ensure that the specimen is taken to the laboratory promptly or refrigerated until it can be transported.
2. Assist the patient to sit upright to facilitate lung expansion and have the patient rinse their mouth to prevent food parti- cles or other debris from being in the sputum specimen. 3. Splint the abdominal or chest incisions with a pillow to help prevent incisional pain. 4. Instruct the patient to inhale deeply two times and then take a third deep breath and cough while exhaling. This expands the lungs and opens the airways to allow mucus production with cough. 5. Instruct the patient to expectorate the mucus into a sterile specimen container. Ask the patient to avoid touching the inside of the container with their mouth or tongue, and avoid touching the inside with your hands to prevent cross-contamination. 6. Repeat Steps 4 and 5 until approximately 30 mL of sputum has been obtained. This is the minimum amount needed for laboratory testing. 7. Follow the Ending Implementation Steps located on the inside back cover. For Obtaining a Sputum Specimen by Suction 2. Follow the steps for suctioning the nasopharynx in Skill 28.6 except that when you assemble the suction tubing and suc- tion catheter, you will attach a sputum trap between them. When you suction the nasopharynx, you will go deep into the trachea and obtain sputum that will be suctioned into the sputum trap for testing.
Sample Documentation
10/10/28 1330 Sputum spec of 30 mL of thick yellow mucus obtained. C/o fatigue after coughing effort. Resp increased to 26/min. Assisted to Fowler’s position to rest. Sputum spec labeled and delivered to laboratory. ______________________ ___________________________________________________ Nurse’s signature and credentials
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