How to Collect Sputum and Feces Sample 1

1. Sputum
Sputum is mucus and is the name used for the coughed-up material (phlegm)
from the lower airways (trachea and bronchi). Sputum is the material released from
the lungs, bronchus, and trachea through the mouth. Usually called expectoratorian.
Normal adults can produce mucus (glandular secretions) of 100 ml in the
respiratory tract daily. This mucus is herded into the parynx by a ciliated cleansing
mechanism of the epithelium lining the respiratory tract. Abnormal circumstances
of excessive mucus production (due to physical, chemical, or infectious disorders
occuring in the mucous membranes), causes the cleaning process to be inadequately
normalized as before, so that the mucus is heavily loaded. When this happens, the
mucous membrane will be aroused, and mucus will be excreted by intrathoracic and
intraabdominal pressures. Cured, the air came out with a quick acceleration and
brough the mucus secretions that buried earlier. The mucus will come out as
sputum.

Figure 1.1 Abnormal Sputum

1.1 Purpose
A sputum culture is a test to detect and identify bacteria or fungi that infect
the lungs or breathing passages. Sputum is a thick fluid produced in the lungs and
in the adjacent airways. Sampling may be performed by sputum being expectorated
(produced by coughing), induce (saline is sprayed in the lungs to induce sputum
production), or taken via an endotracheal tube with a protected specimen brush
(commonly used on patients on respirators) in an intensive care setting.

By: Novira Adekayanti

 How to Collect Sputum and Feces Sample 2

1.2 Tools and Materials

- Special Plastic Cup

Figure 1.2 Plastic Cup for Sputum

1.3 How to Collect a Sputum Sample

Your doctor or nurse will give you a special plastic cup for collecting your
sputum. Follow these steps carefully :
1. The cup is very clean. Don’t open it until you are ready to use it.
2. As soon as you wake up in the morning (before you eat or drink
anything), brush your teeth and rinse your mouth with water. Do not use
mouthwash.
3. If possible, go outside or open a window before collecting the sputum
sample. This helps protect other people from TB germs when you cough.
4. Take a very deep breath and hold the air for 5 seconds. Slowly breathe
out. Take another deep breath and cough hard until some sputum comes
up into your mouth.
5. Spit the sputum into the plastic cup.
6. Keep doing this until the sputum reaches the 5 ml line (or more) on the
plastic cup. This is about 1 teaspoon of sputum.
7. Screw the cap on the cup tightly so it doesn’t leak.
8. Wash and dry the outside of the cup.
9. Write on the cup the date you collected the sputum.
10. Put the cup into the box or bag the nurse gave you.

By: Novira Adekayanti

 How to Collect Sputum and Feces Sample 3

11. Give the cup to your clinic or nurse. You can store the cup in the
refrigerator overnight if necessary. Do not put it in the freezer or leave it
at room temperature.

2. Feces
Feces (or faeces) are the solid or semisolid remains of the food that could not
be digested in the small intestine. Bacteria in the large intestine further break down
the material. Feces contain a relatively small amount of metabolic wasteproducts
such as bacterially altered bilirubin, and the dead epithelial cells from the lining of
the gut. Feces examination or fecal culture is a way to take feces as an examination
material, ie complete examination and culture examination: food type and
peristaltic motion affect the shape, quantity and its consistency.
2.1 Purpose
According to the American Association for Clinical Chemistry, a fecal
culture test may be done if you have chronic, persistent digestive problems.
Symptoms might include:
- Abdomnal pain
- cramping

- nausea

- vomiting

- diarrhea

- blood or mucus in your stool

- fever

Before ordering the test, your doctor will ask questions to learn if a food-
borne illness has caused your symptoms. For example, you might experience
similar reactions if you recently ate uncooked eggs or improperly processed foods.
Your doctor will also ask if you have traveled outside of the United States.
International travelers are sometimes at a higher risk of food contamination,
especially if they’ve been in developing nations.
People with healthy immune systems typically recover naturally from minor
digestive infections without any problems. However, those with weakened immune

By: Novira Adekayanti

 How to Collect Sputum and Feces Sample 4

systems may need antibiotics to help fight infections. This can include infants, older
adults, and people with certain diseases, such as HIV/AIDS.
Your doctor may order more than one stool test over a period of time. This
can help them check if treatments are working or your infection is getting worse.
2.2 Tools and Materials
- Hat Toilet

Figure 1.3 Hat toilet

- Plastic Wrap

Figure 1.4 Plastic Wrap

- Newspaper

Figure 1.5 Newspaper

By: Novira Adekayanti

 How to Collect Sputum and Feces Sample 5

- Tube stool cup fecal

Figure 1.6 Tube stool cup fecal

2.3 How to Collect Stool Sample/Fecal Examination

1) Avoid medicine that will affect the sample. Avoid taking certain
medicines before collecting it. This includes anything that might soften
your stools, such as Pepto Bismol, Maalox, mineral oil, antacids and
Kaopectate. Also, if you have had a Barium Swallow, a metallic
compound used to see abnormalities in the esophagus and stomach
during an x-ray, you should postpone taking the stool sample.
2) Consult with your doctor. He or she will provide you with the necessary
equipment for collecting your stool sample, including a container for
storing the sample. Ask about the procedure and if you can receive a
“hat.” Follow your doctor's instructions and read any directions that
come with your equipment carefully. Keep in mind that toilet water,
urine, paper, and soap can all ruin the stool sample, so make sure that
you have a way to protect your stool from becoming contaminated by
these things. Set up a way to catch your stool sample ahead of time.
3) Prepare your toilet with a hat. The hat is a plastic device that looks like
its namesake and is used to catch the feces so that it does not come into
contact with toilet water. Ask your doctor if one is available, because it

By: Novira Adekayanti

 How to Collect Sputum and Feces Sample 6

will make the process easier. The hat will fit neatly over a portion of the
toilet seat. To put the hat in place, lift up the toilet seat, place the hat
over the bowl, and then close the toilet seat again. Position yourself on
top of the portion of the bowl covered by the hat.
4) Cover your toilet bowl with plastic wrap. If your doctor does not
provide you with a hat, then you can also cover the toilet bowl with
plastic wrap. To use plastic wrap, lift up the toilet seat and then place
the plastic wrap across the toilet bowl. Close the toilet seat on the plastic
wrap to help secure it.
5) Lay a sheet of newspaper across your toilet bowl. As a last recourse,
you can also use a large sheet of newspaper to collect your stool sample.
To use a piece of newspaper, lift up the toilet seat and place the
newspaper across the toilet bowl and then close the toilet seat to secure
it.
6) Defecate into the collection device. Be sure to urinate first so that you
do not contaminate the sample. Whether at home or at the doctor’s
office, secure the toilet with either a hat or plastic wrap. Be careful that
all of the sample is collected and does not come into contact with the
toilet water.
7) Deposit sample in the container. Open up one of the containers that the
doctor gave you. There should be a small shovel-like tool attached to
the cap of the container. Use the shovel to scoop a small bit of stool into
the container. Try to take some stool from each end and from the
middle.
8) Dispose of your collection device. Flip over the contents of the
hat/plastic wrap into the toilet. Flush away the stool and deposit the
hat/plastic wrap and any other garbage into a trash bag. Tie the trash
bag in a knot, and put it somewhere that you cannot smell it.
9) Refrigerate the sample. Whenever possible the sample should be
returned immediately. If you are not doing so, it should be refrigerated.
Put the container with the stool in a sealed bag and store in the fridge.

By: Novira Adekayanti

 How to Collect Sputum and Feces Sample 7

Label it with your name, date, and time of collection. Consider an

opaque bag so that no one can see your stool sample.
10) Return the samples to your doctor as soon as possible. Under no
circumstances should you wait more than 24 hours before returning the
sample to a doctor. The bacteria in your stool will grow and change.
Usually your doctor will want the sample back within two hours to get
an accurate result.

By: Novira Adekayanti