Respiratory: Collecting a sputum specimen

Definitions & Key takeaways

A sputum specimen is a sample of mucus and other secretions from deep within the respiratory tract that is coughed up by a patient and collected when a respiratory infection is suspected. It is used to diagnose and monitor lung infections such as pneumonia, tuberculosis (TB), and bronchitis.

Collecting a sputum specimen can be uncomfortable and somewhat embarrassing for patients. So, a healthcare provider needs to maintain patient comfort and privacy as much as possible. The procedure involves having the patient first rinse their mouth with water and then take a few deep breaths followed by forceful coughs directly into a specimen container, which you subsequently seal, label, place in a biohazard bag, and send to the laboratory. After the procedure, remember to report any unusual signs or symptoms to the nurse and document your observations.

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Intro0:00–0:55

Sometimes, the clients you care for may have respiratory complaints. A healthcare provider may order a sputum specimen for a client they suspect may have a respiratory infection, such as pneumonia or other respiratory illnesses, like lung cancer.
A nurse may delegate collection of the sputum specimen to a nursing assistant. A sputum specimen is simply a sample of sputum from a particular client.
Sputum, sometimes referred to as “phlegm,” is made up of mucus as well as some other respiratory secretions that can be coughed up, or expectorated, from the lungs, bronchi, and trachea.
If a client is coughing or spitting up blood, or sputum that contains blood, that’s called hemoptysis, where “hemo-” refers to blood, and “-ptysis” refers to spitting up.
Now, before collecting a sputum specimen, there are a few things you should keep in mind and a few supplies you’ll need to gather and prepare.

General Considerations0:55–1:41

Coughing up or spitting up mucus into a cup can be both uncomfortable and embarrassing for a client. So, it’s important you ensure client privacy and comfort as much as possible throughout the duration of the procedure.
Be sure you’re collecting sputum, which is produced in the respiratory tract, and not saliva or spit, which is produced in the mouth.
The supplies you’ll need are clean gloves, a small cup of water, an emesis basin, a sterile specimen container with its lid, facial tissues, disinfectant wipes, client identification labels, the laboratory requisition form, and a small biohazard plastic bag.
All right, first, wash your hands, put on some clean gloves, and greet the client. Identify them using two identifiers: usually their full name and birth date, being sure to check that information against the client’s identification bracelet, labels, and laboratory requisition form.

Procedure1:41–3:33

Next, provide the client with a small cup of water to rinse their mouth in order to clear away any microbes that may be present in their mouth; ask them to spit into an emesis basin after rinsing.
Be sure to avoid using mouthwash as it may kill microbes in the sputum and, consequently, lead to inaccurate test results.
Next, remove the lid from the sterile specimen container and hand the container to the client, instructing them to only touch the outside of the container as touching the inside may interfere with the accuracy of the test.
Next, explain to the client that they should take 2-3 deep breaths, each followed by full expiration, before taking a final deep breath followed immediately by a forceful cough directly into the specimen container in order to ensure they provide sputum from the lungs, bronchi, and trachea.
Ask the client to repeat the few breaths followed by the forceful cough until you’ve collected 5-10 milliliters, or 1-2 teaspoons, of sputum.
Then, take the container from the client and offer them facial tissues they can use to clean up. Next, place the lid on the container, being sure to seal it tightly.
If there is any sputum on the outside of the container, wipe it away with disinfectant wipes. Apply a client identification label to the container, place it inside of the small biohazard plastic bag, and apply a client identification label to the biohazard bag.
Remove and throw away your gloves, wash your hands, and send the collected specimen along with the laboratory requisition form to the laboratory immediately.
There are a few things you should report to the nurse right away. These include the presence of blood in the sputum, if they are unable to produce any sputum, as well as any changes to the client’s vital signs.

Reporting and Recording3:33–3:58

You should also document and report the date and time you collected the specimen; how much sputum was collected; how well the client tolerated the procedure; as well as the color, odor, and consistency of the sputum collected.
All right, as a quick recap… A sputum specimen is a sample of mucus and other secretions from deep within the respiratory tract that is coughed up by a client and collected when a respiratory infection is suspected.

Recap3:58–4:40

Collecting a sputum specimen can be uncomfortable and embarrassing for clients. So, it’s important to maintain client comfort and privacy as much as possible.
The procedure involves having the client first rinse their mouth with water and then take a few deep breaths followed by forceful coughs directly into a specimen container, which you subsequently seal, label, place in a biohazard bag, and send to the laboratory.
After the procedure, remember to report any unusual signs or symptoms to the