Purpose

• Respiratory disorders cause the lungs, bronchi, and trachea to secrete mucus. Mucus from the respiratory system is called sputum when expectorated (expelled) through the mouth.
• Sputum specimens are studied for blood, microbes, and abnormal cells. The person coughs up sputum from the bronchi and trachea. This is often painful and hard to do. It is easier to collect a specimen in the morning. Secretions collect in the trachea and bronchi during sleep. They are coughed up on awakening.
• To collect a specimen, have the person rinse the mouth with water. Rinsing decreases saliva and removes food particles. Mouthwash is not used. It destroys some microbes in the mouth. Also follow these rules for collecting specimens:
  • Follow the rules of medical asepsis.
  • Use a clean container for each specimen. Use the correct container.
  • Do not touch the inside of the container or lid.
  • Label the container in the person’s presence. Provide clear, accurate information.
  • Collect the specimen at the correct time.
  • Place the specimen container in a labeled biohazard plastic bag. Do not let the container touch the outside of the bag. Seal the bag.
  • Take the specimen and requisition slip to the laboratory or storage area.

Equipment

Roll cursor over items to see labels. For the purposes of clearly depicting the equipment, a barrier is not shown in this photo. When providing care, a barrier should always be placed on the surface before placing the equipment.

Tissues

Specimen bag

Sputum specimen container and lid

Specimen label

Laboratory requisition slip

Gloves

Delegation

• Follow delegation guidelines. Before collecting a sputum specimen, obtain this information from the nurse and care plan:
  • When to collect the specimen
  • How much sputum is needed—usually 1 to 2 teaspoons
  • If the person uses the bathroom
  • If the person can hold the sputum container
  • What observations to report and record
  • When to report observations
  • What patient or resident concerns to report at once

Preparation

• Observe quality-of-life measures.
• Review the information under Delegation and Safety and Comfort.
• Practice hand hygiene.
• Before going to the person’s room, collect the items on the equipment list, from the laboratory requisition slip through the biohazard label.
• Arrange collected items in the person’s bathroom.
• Practice hand hygiene.
• Identify the person. Check the ID bracelet against the requisition slip. Compare all information. Also call the person by name.
• Label the specimen container in the person’s presence.
• Collect gloves and tissues.
• Provide for privacy. If able, the person uses the bathroom for the procedure.

Safety

• Follow Standard Precautions and the Bloodborne Pathogen Standard to prevent contact with mucus. It may contain blood or microbes.
• The doctor may order isolation precautions if the person has or may have tuberculosis (TB). Protect yourself by wearing a TB respirator.

Comfort

• The procedure can embarrass the person. Coughing and expectorating sounds can disturb others. Also, sputum is not pleasant to look at. For these reasons, privacy is important. Cover the specimen container and place it in a bag. Some sputum specimen containers are cloudy in color to hide the contents.

Follow-up Care

• Provide for comfort.
• Place the call light within reach.
• Raise or lower the bed rails. Follow the care plan.
• Unscreen the person.
• Complete a safety check of the room.
• Practice hand hygiene.
• Deliver the specimen and requisition slip to the laboratory or storage area. Follow agency policy. Wear gloves.
• Remove and discard the gloves. Practice hand hygiene.

Reporting/Recording

• Report and record your observations, including:
  • The time the specimen was collected
  • The amount of sputum collected
  • How easily the person raised the sputum
  • Sputum color—clear, white, yellow, green, brown, or red
  • Sputum odor—none or foul odor
  • Sputum consistency—thick, watery, or frothy (with bubbles or foam)
  • Hemoptysis (bloody sputum)
  • If the person was not able to produce sputum
  • Any other observations