Which procedure would the nurse follow when collecting a stool specimen for an occult blood laboratory test?

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March 2005 - Volume 35 - Issue 3

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Stool Specimen and Culture

A stool culture is the process of growing or culturing organisms existing in feces to see if any of them cause disease. The most common is the ova and parasites test, a microscopic examination of feces for detecting parasites such as amoebas or worms. Stools specimen are often tested for blood. Guaiac or HemOccult test may be done in the laboratory but are sometimes done at the nursing station to test a stool for occult blood.

Supplies and Equipment

• Supplies and equipment required to collect a stool specimen are:
• Gloves
• Clean bedpan and cover (an extra bedpan or urinal if the patient must void)
• Specimen container and lid
• Wooden tongue blades
• Paper bag for used tongue blades
• Labels
• Plastic bag for transport of container with specimen to laboratory

Procedure

1. Discuss the test and the procedure with the patient. Ask him to tell you when he feels the urge to have a bowel movement.
2. Wear gloves when handling any bodily discharge.
3. Bedpan should be provided when the patient is ready. If the patient wants to urinate first, provide the urinal for a male patient or provide the extra bedpan for a female patient. Avoid mixing urine or regular toilet paper into the sample.
4. With the use of a tongue blade, transfer a portion of the feces to the specimen container. Don’t touch the specimen because it is contaminated. It is not necessary to keep the specimen sterile because the gastrointestinal tract is not sterile.
5. Immediately cover the container and label it with the patient’s name and other needed information.
6. Fill out the appropriate laboratory request form completely, noting any special examination ordered.
7. Take the specimen to the lab immediately; examination for parasites, ova, and organisms must be made while the stool is warm.
8. With regard to an infant patient, place the diaper in a leakproof bag, label it, and take the diaper and request form to the lab as soon as possible. However, it can be difficult to keep urine away from the stool sample.

Guaiac Fecal Occult Blood Test (gFOBT)

The stool guaiac test finds hidden (occult) blood in the stool (bowel movement). It is the most common form of fecal occult blood test (FOBT) in use today.

Supplies and Equipment

• Test kit (with detailed instructions)
• Test cards
• Brush or wooden applicator
• Gloves

Preparation

Do not allow the patient to eat red meat, any blood-containing food, cantaloupe, uncooked broccoli, turnip, radish, or horseradish for 3 days prior to the test. The patient may need to stop taking medicines that can interfere with the test. These include vitamin C and non steroidal anti inflammatory medicines such as ibuprofen and aspirin. However, never let the patient stop such medication without consulting the physician. There is no discomfort when the test is done since it only involves normal bowel function.

Procedure

1. Discuss the test and the procedure with the patient. And prepare himself when he feels the urge to have a bowel movement.
2. Tell the patient that he needs to collect a sample from his bowel by placing a sheet of plastic wrap or paper loosely across the toilet bowl to catch the stool or he can use a dry container to collect the stool.
3. Inform the patient to not mix the sample with urine. Tell him to flush the remaining stool down the toilet. Remind the patient not to take samples from the toilet bowl water.
4. Allow the patient to use the wooden applicator or a brush to smear a thin film of the stool sample onto one of the slots in the test card or slide.
5. Next, the patient needs to collect a specimen from a different area of the same stool and smear a thin film of the sample onto the other slot in the test card or slide.
6. Close the slots and put the name of the patient and the date on the test kit.
7. Instruct the patient to repeat the test on his next two bowel movements to improve the accuracy of the test.
8. Remove gloves and wash hands thoroughly.
9. Send the specimen to the laboratory.
10. Inform the patient that he may resume his usual diet and medications as ordered.

Sources:

https://sites.google.com/site/nursingstudentsnote/family-blog/diagnostictestandspecimencollection

Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

What Do You Think?

What is the procedure for collecting a stool specimen?

How does a nurse collect a stool specimen?

What precautions should the nurse take when obtaining the blood specimen for testing?

What are the instructions and precautions needed in stool sample collection and transportation?