ATI Nursing Skills Obtaining Sputum Sample PDF

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Summary

ATI Nursing Skills Obtaining Sputum Sample...

Description

ACTIVE LEARNING TEMPLATE:

Nursing Skill

STUDENT NAME _____________________________________

Obtaining Sputum Culture SKILL NAME____________________________________________________________________________ REVIEW MODULE CHAPTER ___________

Description of Skill - Bacteriologic examination of sputum collected by expectoration or tracheal suctioning - Acid-fast sputum smear: may disclose evidence of mycobacterial infection such as TB

Indications - to isolate and identify causes of pulmonary infections - to help Dx respiratory diseases such as bronchitis, TB, lung abscess, and Pneumonia

CONSIDERATIONS

Nursing Interventions (pre, intra, post) Expectorant Pre- Hand Hygiene - Confirm pt ID using at least 2 identifiers Intra- Instruct pt to take 2-3 deep breaths and then take another deep breath and forcefully cough with exhalation and expectorate into the container; doing this in the early morning is best - Gram Stain of expectorated sputum must be examined to make sure that its a representative specimen of secretions from the lower respiratory tract (many WBC, few epithelial cells) - If the cough is non-productive, use chest physiotherapy or nebulization to induce sputum - Don't use more that 2020% propylene glycol with H2O as an inducer for a specimen scheduled for TB Culturing because higher concentrations inhibit the growth of M. TB Post-Close container securely - Dispose of equipment properly - seal container in a leak proof bag -send to lab immediately For Tracheal Suctioning Pre- Hand Hygiene - Give O2 to the pt prior to procedure - Attach the suction trap to the suction catheter - Lubricate the catheter with normal saline and pass through the pt nostrils without suction I

Outcomes/Evaluation Normal - Common floras incl. alpha-hemolytic streptococci, Neisseria species and ditheroid -Presence of common flora doesn't rule out infection Abnormal Results - Because sputum is invariably contaminated with normal oropharyngeal flora, a culture must be interrupted in light of the pts overall clinical condition - Isolation of M. tuberculosis, TB - Isolation of pathogenic organisms most often Streptococcus pneumoniae, Klebsiella pneumoniae, Hemophilus influenza, Staphylococcus aureus and Pseudomonas aeruginosa

Potential Complications - Hypoxemia - Cardiac arrythmias - Laryngospasms - Bronchspasms - Pneumothorax - Perforation of the trachea or bronchus - trauma to Respiratory Structures - Bleeding

ACTIVE LEARNING TEMPLATES

Client Education -No dietary restrictions are required prior to procedure but specimens are best collected in the morning before eating, drink only water, and before using mouthwash - Explain that specimens may be collected on three consecutive mornings if Mycobacterium TB is suspected - Explain who will perform the test and when it will be done - Inform the pt that this requires a sputum specimen - Inform the pt that TB results take up to 2 months - Tell the pt that results for all other cultures are usually available in 48-72 hrs

Nursing Interventions - Monitor O2 Stats - Monitor V/S, Respiratory Status -if pt becomes hypoxic or cyanotic during the procedure remove the catheter immediately - Give O2 - Report to provider...