DIAGNOSTIC

LABORATORY TEST
 SPUTUM
COLLECTION
What is a sputum culture?
A sputum culture is a test that checks for bacteria or another type of organism
that may be causing an infection in your lungs or the airways leading to the lungs.
Sputum, also known as phlegm, is a thick type of mucus made in your lungs. If
you have an infection or chronic illness affecting the lungs or airways, it can make
you cough up sputum.
What is it used for?
A sputum culture is most often used to:
Find and diagnose bacteria or fungi that may be causing
an infection in the lungs or airways
See if a chronic illness of the lungs has worsened
See if treatment for an infection is working
NURSING ASSESSMENT/ CONSIDERATIONS FOR PROCEDURE
Perform hand hygiene before patient contact.
Introduce yourself to the patient and family.
Verify the correct patient using two identifiers.
Check the practitioner’s orders for the type of sputum analysis and specifications (e.g., amount of sputum,
number of specimens, time of collection, method of obtaining specimens) and initiate appropriate isolation
precautions until the results are obtained.
Assess the patient’s ability to cough and expectorate a specimen.
Determine when the patient last ate. If the patient has recently eaten, this may trigger vomiting.
Determine the type of assistance the patient needs to obtain a specimen.
Assess the patient’s respiratory status, including respiratory rate, depth, and pattern, and the color of
mucous membranes.
Assess the patient’s and family’s understanding of the reasons for and the risks and benefits of the
procedure.
PREPARATIONS FOR PROCEDURE

Gather the necessary supplies, including the appropriate PPE. Take airborne precautions when
caring for a patient who is suspected of having TB or other airborne transmissible diseases.
Determine the patient’s ability to assist with the collection of the specimen.
Demonstrate deep breathing and expectoration. For the collection of an expectorated specimen,
ensure that the patient rinses the mouth or brushes teeth with water, as developmentally
appropriate.
Ensure that the patient does not use mouthwash or toothpaste because they may decrease the
viability of the microorganisms and alter the culture results.
Position the patient appropriately, To collect the specimen via coughing and expectoration,
position the patient in the semi-Fowler position, sitting on the side of the bed, in a chair, or
standing.
Rationale: The semi-Fowler position promotes full lung expansion and aids the ability to cough.
PROCEDURE
Perform hand hygiene and gown, mask, eye protection or face shield, and gloves. If necessary, ensure that an
assistant is available and wearing appropriate PPE.
Verify the correct patient using two identifiers.
Explain the procedure to the patient and family and ensure that they agree to treatment.
Provide the patient with the specimen container (e.g., sputum trap) or have the assistant hold the container.
Instruct the patient or family member not to touch the inside of the container.
Instruct the patient to take a slow, deep breath and to cough after a full inhalation.
Rationale: Expectorant must come from the lungs. Saliva is not sputum.
Instruct the patient to expectorate sputum directly into the specimen container.
Instruct the patient to repeat coughing until a sufficient quantity (a minimum of 5 ml of sputum) is collected.
Secure the top on the specimen container tightly.
Offer tissues after the patient expectorates. Dispose of the tissues in an emesis basin or appropriate waste
receptacle.
Wipe off any sputum present on the outside of the container with an organization-approved disinfectant wipe.
Ensure that the container is tightly closed before wiping to prevent contamination of the specimen.
Offer the patient mouth care, if desired.
In the presence of the patient, label the specimen per the organization’s practice. Place the labeled specimen in a
biohazard bag and transport it to the laboratory immediately per the organization’s practice.
Discard supplies, remove PPE, and perform hand hygiene.
Document the procedure in the patient’s record.
THROAT
CULTURE
What is a throat culture?
A throat culture requires swabbing the throat, streaking a culture
plate, and allowing the organisms to grow for isolation and
identification of pathogens.
Purpose of Throat Culture
● To isolate and identify group A beta hemolytic
streptococci.
● To screen asymptomatic carriers of pathogens.
NURSING PREPARATIONS/ CONSIDERATION FOR THE
PROCEDURE
1. Confirm the patient’s identity using two patient identifiers according to
facility policy.

2. Explain to the patient that the throat culture is used to identify

microorganisms that may be causing his symptoms or to screen for
asymptomatic carriers.

3. Inform the patient that he doesn’t need to restrict food and fluids for the
test.

4. Advise the patient that a specimen will be collected from his throat.
Describe the procedure, and warn him that he may gag during the swabbing.

5. Check the patient’s history for recent antimicrobial therapy.

6. Determine immunization history if it’s pertinent to the preliminary diagnosis.

PROCEDURE
1. Ask the patient to tilt his head back and close his eyes.

2. With the throat well illuminated, check for inflamed areas, using a tongue blade.

3. Swab the tonsillar areas from side to side; include any inflamed or purulent sites.
Don’t touch the tongue, cheeks, or teeth with the swab.

4. Immediately place the swab in the culture tube. If a commercial sterile collection
and transport system is used, crush the ampule and force the swab into the medium
to keep it moist.

5. Note recent antimicrobial therapy on the laboratory request.

6. Label the specimen with the patient’s name, physicians name, date and time of
collection, and origin of the specimen. Also indicate the suspected organism.
Nursing Interventions
1. Send the specimen to the laboratory immediately. Unless a commercial sterile collection
and transport system is used, keep the container upright during transport.

Interfering Factors
● Failure to report recent or current antimicrobial therapy on the laboratory request
(possible false negative).

● More than a 15 minute delay in sending the specimen to the laboratory.

Precautions
● Obtain the throat specimen before beginning antimicrobial therapy.

● Wear gloves when performing the procedure and handling of specimens.

REFERENCES:
https://elsevier.health/en-US/preview/specimen-sputum-peds
https://medlineplus.gov/lab-tests/sputum-culture/
https://nursingcrib.com/medical-laboratory-diagnostic-test/throat-culture-procedure/