Specimen Collection: Lesson 4 Post-Test
The patient is reading some literature on screening for colon cancer. The patient asks, "What is melena?" The nurse is correct to respond: "Undigested fat which causes a white or clay-colored foul-smelling frothy stool." "Black tarry feces caused by the digestion of blood in the gastrointestinal tract." "Pain with defecation, usually due to the presence of polyps." "Noticeable bright red blood in the stool, typically from hemorrhoids."
"Black tarry feces caused by the digestion of blood in the gastrointestinal tract." Melena is the darkening of feces caused by the digestion of blood in the GI tract.
The nurse is instructing the NAP how to perform a Hemoccult test. Which statement, if made by the NAP, indicates further teaching is necessary and would require correction? "I should wear nonsterile clean gloves during stool testing." "When preparing the Hemoccult slide, I should moisten the windows of the testing slide before applying the fecal sample." "The stool sample is applied to each of the two little boxes on the inside of the Hemoccult slide." "Blue discoloration indicates the presence of blood in the stool."The nurse is instructing the NAP how to perform a Hemoccult test. Which statement, if made by the NAP, indicates further teaching is necessary and would require correction? "I should wear nonsterile clean gloves during stool testing." "When preparing the Hemoccult slide, I should moisten the windows of the testing slide before applying the fecal sample." "The stool sample is applied to each of the two little boxes on the inside of the Hemoccult slide." "Blue discoloration indicates the presence of blood in the stool."
"When preparing the Hemoccult slide, I should moisten the windows of the testing slide before applying the fecal sample." Apply the fecal sample to dry and debris free slide windows. Blue discoloration indicates the presence of blood in the stool. A green discoloration means it is negative for the presence of blood. The sample must go on the correct side of the slide to be accurate. Clean disposable gloves should be worn for personal protection.
The nurse wants to assess the patient for factors which may place the patient at risk for gastrointestinal bleeding. Which of the following would increase the patient's potential for having a positive Hemoccult test? (Select all that apply.) Anticoagulants (heparin, warfarin sodium) Long-term use of steroids Antidiabetic agents (oral hypoglycemics) Acetylsalicylic acid (aspirin) Long term use of nonsteroidal anti-inflammatory drugs (NSAIDs) A recent blood transfusion
Anticoagulants (heparin, warfarin sodium) Long-term use of steroids Acetylsalicylic acid (aspirin) Long term use of nonsteroidal anti-inflammatory drugs (NSAIDs) Anticoagulants increase risk for bleeding in the gastrointestinal tract, even from minor trauma to mucosa. Long-term use of steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetylsalicylic acid (aspirin) can irritate mucosa and result in bleeding.
The patient had a positive Hemoccult test. Which of the following could affect the test result? (Select all that apply.) Ascorbic acid (vitamin C) Antibiotics Diets rich in carbohydrates Diet high in poultry and fish Povidone-iodine
Ascorbic acid (vitamin C) Diet high in poultry and fish Povidone-iodine Specimens will be positive if contaminated by menstrual blood, hemorrhoid blood, or povidone-iodine. Diets rich in meats, green leafy vegetables, poultry, and fish may produce false-positive results. Medications that affect results include anti-inflammatory agents, ascorbic acid (vitamin C), and nonsteroidal agents. Antibiotics and carbohydrates do not affect results.
The nurse is performing a Hemoccult test on stool of a patient with a low hemoglobin and hematocrit. Which one of the following steps would be inaccurate and would require correction? Perform hand hygiene, apply clean gloves. Use tip of wooden applicator to obtain small portion of feces. Apply this smear of stool on paper in first box. Obtain second fecal specimen from different area of stool and apply thin smear to second box of slide. Close slide cover, turn slide over, open cardboard flap and apply one drop of Hemoccult developing solution to each box. Read results after 30 to 60 seconds. Dispose of gloves and test slide. Perform hand hygiene.
Close slide cover, turn slide over, open cardboard flap and apply one drop of Hemoccult developing solution to each box. Two drops of Hemoccult developing solution should be applied to each box.
The nurse is going to perform a Hematest on a fecal sample. Which of the following would be an incorrect action if made by the nurse? The nurse delegates testing the stool for blood using a Hematest to NAP. The Hematest tablets are protected from light and moisture. The Hematest tablets are placed on the guaiac paper and the stool sample is placed on top of the Hematest tablet. Water applied to the Hematest tablets flows onto the guaiac paper.
The Hematest tablets are placed on the guaiac paper and the stool sample is placed on top of the Hematest tablet. The sample is placed on the guaiac paper and the tablet is then placed on top. These tablets react to moisture and light; exposure to these elements could result in altered test results.
The NAP reports that the Hemoccult test was positive. This means that: The patient has colon cancer. The test result turned blue. Absence of gastrointestinal bleeding. No further testing is required.
The test result turned blue. Bluish discoloration is guaiac positive. Other conditions besides colon cancer can cause a positive Hemoccult result, such as upper gastrointestinal ulcers, localized gastric parasitic infections or intestinal irritation. A single positive test result does not confirm bleeding. For confirmed positive results, the test must be repeated at least three times while patient is on meat-free, high-residue diet.