Type of test Sputum

Normal findings

 Normal upper respiratory tract

 Test explanation and related physiology

 Sputum cultures are obtained to determine the presence of pathogenic bacteria in patients with respiratory infections (e.g., pneumonia). A Gram stain is the first step in the microbiologic analysis of sputum. Staining of sputum provides an opportunity to classify bacteria as gram positive or gram negative. This may be used to guide drug therapy until the culture and sensitivity (C&S) report is complete. The sputum sample is then applied to a series of bacterial culture plates. The bacteria that grow on those plates 1 to 3 days later are then identified. Determinations of bacterial sensitivity to various antibiotics are done to identify the most appropriate antimicrobial drug therapy. This is done by observing a ring of growth inhibition around an antibiotic plug in the culture medium.

Sputum for C&S should be collected before antimicrobial therapy is initiated unless the test is being performed to evaluate the effectiveness of medications already being given. Preliminary reports are usually available in 24 hours. Cultures require at least 48 hours for completion. Sputum cultures for fungus and Mycobacterium tuberculosis may take 6 to 8 weeks.

Procedure and patient care

 Before

* Explain the procedure for sputum collection to the patient.

* Remind the patient that sputum must be coughed up from the lungs and that saliva is not sputum.

• Hold antibiotics until after the sputum has been collected.

• If an elective specimen is to be obtained, give the patient a sterile sputum container on the night before the sputum is to be collected so that the morning specimen may be obtained on arising.

* Instruct the patient to rinse out his or her mouth with water before the sputum collection to decrease contamination of the sputum by particles in the oropharynx.

During

• Note that sputum specimens are best when the patient first awakens in the morning and before eating or drinking.

• Collect at least 1 teaspoon of sputum in a sterile sputum container.

• Usually obtain sputum by having the patient cough after taking several deep breaths.

• If the patient is unable to produce a sputum specimen, stimulate coughing by lowering the head of the patient’s bed or giving the patient an aerosol administration of a warm hyper tonic solution.

 • Note that other methods to collect sputum include endotracheal aspiration, fiberoptic bronchoscopy, and transtracheal aspiration.

After

* Inform the patient to notify the nurse as soon as the sputum is collected.

• Label the sputum and send it to the laboratory as soon as possible.

• Note any current antibiotic therapy on the laboratory slip.

Abnormal findings

- Bacterial infection (e.g., pneumonia)

- Viral infection

- Atypical bacterial infection (e.g., tuberculosis)

اخر الاخبار

اخبار العتبة العباسية المقدسة

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المزيد

الآخبار الصحية

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المزيد

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المزيد

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