PRIN 2_L10_Non-Blood Specimens

• urine - most analyzed among the non-body fluids
• urine analysis functions:

  • •Provides a picture of the many metabolic functions of the body
  • Helps in monitoring wellness•Helps in diagnosing and treating UTI•
  • Helps in detecting and monitoring the progress of treatment in metabolic diseases
  • Helps in identifying the effectiveness of an administered therapy, as well as checking if the patient exhibits any therapy-related complications
• Accuracy of urine analysis results largely depends on several factors:

  • Collection method
  • Container used
  • Transportation and handling of specimen
  • Timeliness of the testing
• Routine urinalysis


  Frequently ordered urine test that screens patient for any urinary or systematic disorders
• Routine urinalysis covers


  • Physical analysis (color, clarity, and odor)
  • Chemical analysis (pH, specific gravity, glucose, protein, etc.)
  • Microscopic analysis (cells, crystals, and microorganisms)
• Urine specimen


  • Random specimen is acceptable, but midstream collection is recommended & ideal to ensure no contamination by genital secretions, pubic hair, or bacteria surrounding the urinary opening
  • Specimen container should be clear & dry with tight-fitting lids & chemically cleaned
• Urine specimen transport


  1. Should be transported to the lab immediately

  2. Could be held at room temperature for 2 hours

  3. Could be refrigerated if transport will take longer than prescribed
• urine culture and sensitivity (C&S) - Requested if the patient has symptoms of a UTI

  • Should be midstream clean-catch urine collection placed in a sterile container
  • A measured portion of the urine is cultured on a special nutrient medium for 18 – 24 hrs.
  • The medium will encourage the growth of microbes
  • If a microbe is present & identified, a sensitivity or antibiotic susceptibility test is performed
• urine cytology studies - Requested by the physician to detect cancer, cytomegalovirus, and other viral and inflammatory diseases in the urinary system

  • A fresh clean-catch specimen is required
  • A smear from the cells of the lining of the urinary tract is stained using PAP mtd & examined for abnormal cells
  • Should be examined immediately
  • If delays can’t be avoided, specimen must be preserved by adding an equal amount of 50% alcohol
• urine drug testing - Performed to detect:

  • Illicit use of recreational drugs
  • Use of anabolic steroids to enhance performance in sports
  • Unwarranted use of prescription drugs
  • Monitors therapeutic drug use to minimize the symptoms associated with the withdrawal & confirms drug overdose
  • Random sample is placed in a chemically clean container with lid and submitted for testing
• urine glucose and ketone testing - Performed to screen diabetes and to determine the glucose level for patients who are already diabetic
• Urine ketone level test – used to determine if the patient is suffering from diabetic ketoacidosis
• urine pregnancy testing - Used to confirm pregnancy, which can be detected 8 to 10 days after conception

  • First morning urine specimen is preferred since it has the highest concentration of HCG
• other urine tests

  • electrophoresis
  • heavy metals (copper and lead)
  • myoglobin clearance
  • creatinine clearance
  • porphyrins
• types of urine specimens

  1. Random - collected at any time
  2. First morning/8-hour urine specimen – collected immediately upon waking up from 8 hours of sleep
  3. Fasting – a second morning or second specimen voided after fasting (glucose monitoring)
  4. Timed – collected at specific times or pooled throughout a specific time period
• examples of timed urine samples:

  • Tolerance test (glucose) – fasting, ½ hour, 1 hour, etc..
  • 2 – hour postprandial – two hours after a meal
  • 24 – hour – collection and pooling of all urine that is voided in 24 hours
  • Double – voided – waiting time of approximately 30 minutes after emptying the bladder
• Urine collection methods


  • Regular voided
  • Midstream
  • Midstream clean-catch
  • Catheterized
  • Suprapubic aspiration
  • Pediatric
• Regular voided


  The patient voids or urinates into a clean container
• Midstream


  The patient voids or urinates into the toilet first, interrupts the urination for a while, and then restarts into the container with the last urine flow voided in the toilet
• Midstream clean-catch


  Special cleaning is performed on the genital area of the patient before collection
• Catheterized


  Urine of patient is collected from a sterile catheter inserted through the urethra into the bladder
• Suprapubic aspiration


  Urine of patient is collected by inserting needle directly into the bladder and aspirating the urine by the use of a sterile syringe
• Pediatric


  When the patient is a child who is not potty trained, urine is collected in a plastic bag and checked every 15 minutes until the required volume is collected
• amniotic fluid - Clear, colorless to pale-yellow liquid contained in the amniotic sac that surrounds and cushions the fetus during pregnancy

  • Collected by the physician using transabdominal amniocentesis preferably 15 weeks of gestation
  • Guided by the ultrasound machine and about 10 ml of fluid is aspirated from the amniotic sac through the needle inserted in the mother’s abdominal wall into the uterus
  • Done to detect any genetic disorder; check any problem in fetal devt.; and verify the gestational age.
  • Should be protected from light and transported immediately to the lab
• cerebrospinal fluid (CSF) - Refers to the liquid that surrounds the brain and spinal cord; Clear, colorless and obtained by the physician using lumbar puncture or spinal tap

  • Used to diagnose meningitis and other disorders such as brain abscess, CNS cancer, and multiple sclerosis
  • Routine tests performed include cell counts, chloride, glucose, & total protein
  • Collected in 3 special sterile tubes (1st tube – chemistry & immunology test; 2nd tube – microbiological studies; and 3rd tube – cell counts)
  • Should be kept at room temp. and sent to the lab for immediate analysis
• gastric fluid/analysis - Performed to check the contents of the stomach for abnormal substances and evaluate the production of acid by evaluating the gastric acid conc.

  • In basal gastric analysis, a tube is passed through mouth & throat (oropharynx), or nose & throat (nasopharynx) into the stomach  after the patient has done fasting for a specified time period.
  • Sample is aspirated to determine acidity before stimulation.
  • Gastric stimulant is administered IV after the specimen collection. A series of collection will follow with timed intervals.
  • Placed in sterile containers
• nasopharyngeal secretions - Collected and cultured to determine the presence of bacteria that can cause diphtheria, meningitis, pertussis (whooping cough), and pneumonia

  • Collection is performed by gently inserting a dacron or sterile cotton-tipped flexible wire swab through the nose and into the nasopharynx.
  • Swab is rotated and gently removed, then placed in a  properly labeled sterile container containing the transport medium for immediate delivery to the lab
• saliva - Fluid secreted by the glands inside the mouth

  • Used to check the hormone levels & to determine alcohol and drug or substance abuse
  • Needs to be frozen to ensure stability prior to delivery to the clinical laboratory
• semen - A thick yellowish-white fluid that contains sperm released during the male ejaculation

  • Seminal analysis is done to evaluate the fertility and assess the effectiveness of sterilization after a vasectomy procedure
  • Also done for forensic or legal reasons such as criminal investigations involving sexual assault
  • Placed in a sterile container, kept warm, & protected from light
• semen specimen collection:

  • Masturbation
  • Coitus Interruptus (withdrawal method of contraception)
  • Condom method- SILASTIC Condom (non-lubricated condom that contains polymeric silicone)
  • Vaginal vault aspiration
• serous fluid - Found between the membrane that encloses the pleural, pericardial, and peritoneal cavities

  • Pale-yellow in color, watery and its main function is to allow the membranes to pass through each other with minimal friction
  • Effusion or increase in volume indicates inflammation, infection, or decrease in the serum protein level.
  • Collected by the physician by aspiration & placed in tubes depending on type of test
• serous fluid specimen collection and handling:

  Needle aspiration from the respective cavities

  • Pleural- thoracentesis
  • Pericardial- pericardiocentesis
  • Peritoneal- paracentesis
  • Abundant fluid (>100ml) is usually collected.
• serous fluids tubes:

  • EDTA tubes – for cell counts & smears
  • Heparin or Sodium Fluoride tubes – for chemistry tests
  • Non-anticoagulant tubes – for biochemical tests
  • Heparinized tubes – for blood cultures
  • Type of fluid should be indicated on the label as follows: pleural fluid (lungs), peritoneal fluid (abdominal cavity), & pericardial fluid (heart)
• Sputum


  Used to diagnose and/or monitor lower respiratory tract infections like tuberculosis
• Sputum collection procedure


  1. Gargle with water & remove dentures (if any)

  2. Take 3 or 4 deep breaths, inhale and exhale

  3. Cough forcefully on the last breath

  4. Expectorate and expel sputum into the sterile container
• Sputum collection


  • Recommended to be done first thing in the morning since a larger volume has accumulated overnight
  • Recommended to be done at least 1 hour after meal to avoid gagging
• Sputum collection procedure


  Repeat until an adequate amount is collected equivalent to 3 – 5 ml
• Sputum is transported and processed immediately upon arrival at the lab
• sweat - Used to analyze the chloride content of patients under the age of 20 with symptoms of cystic fibrosis (exocrine gland disorder)

  • Can also be used to determine illegal use of drug by placing patches on the skin for an extended period of time which is further confirmed by subsequent drug testing
• sweat chloride test - electrical stimulation in the forearm or thigh (iontophoresis) is used to transport the pilocarpine (sweat-stimulating drug) into the skin.

  • sweat is collected, weight is recorded, & chloride content is analyzed