Specimen Collection
Performing Gastric Occult Blood Testing
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- » Performing Blood Glucose Testing
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Take the Review Test:
Safety
- Discuss the test with the patient to verify the type of procedure scheduled and the procedure site.
- Follow standard precautions when collecting a specimen of blood or body fluid, and take any additional precautions for collecting specimens from patients who are in protective isolation.
- Ensure that specified prerequisite instructions, such as fasting and nothing by mouth (NPO), have been followed or required conditions met before the specimen is collected.
- Observe the specimen, and report immediately to the health care provider if it is tinged with red blood or contains coffee-ground material.
- If the test for occult blood is positive, continue to monitor the patient, and notify the health care provider.
Equipment
(Roll cursor over items to see labels)
Facial tissues
Wooden applicator or 3 mL syringe
60 mL bulb or catheter-tip syringe
Cardboard Gastroccult test slide
Gastroccult developing solution
Clean gloves
PrintableDelegation
The skill of performing gastric occult blood testing on stomach contents in an emesis basin can be delegated to NAP. You cannot delegate the skill if the specimen is to be collected from a nasogastric (NG) tube. Be sure to inform NAP of the following:
- Advise NAP to report immediately if blood or coffee-ground material is visible in the secretions.
- Instruct NAP to save positive specimens for repeat testing.
Preparation
- Assess the patient’s medical history of gastrointestinal (GI) disorders, such as a history of bleeding or colitis.
- Review the patient’s medication record for drugs that contribute to GI disorders.
- Explain the procedure to the patient and/or family members. Discuss why the specimen collection is necessary.
- Assess the patient’s or the family members’ understanding of the need for the test.
Follow-up
- Ask the patient to explain the reason for the procedure.
- Note the color changes on the guaiac paper.
- Note the character of the gastric secretions.
- If the test for occult blood is positive:
- Continue to monitor the patient.
- Notify the health care provider.
Documentation
- Record the results of the test and the presence of any unusual characteristics of gastric contents.
- Report positive test results to the health care provider.
Review Questions
1. What is the initial step in preparing to perform a gastric occult blood test for a patient with recurrent vomiting?
Determine the patient’s ability to help obtain the specimen. - Gather a Gastroccult slide and developing solution.
Review the medications the patient is currently taking.- Perform hand hygiene, and apply treatment gloves.
INCORRECT. It is not necessary for the patient to help obtain a specimen.
INCORRECT. Although appropriate, gathering supplies would not be the initial step in preparing to perform a gastric occult blood test.
CORRECT. Reviewing possible causes of the patient’s recurrent vomiting is the most appropriate first step. Anticoagulants increase the risk of gastrointestinal (GI) tract bleeding, even from minor mucosal trauma, and long-term use of steroids, nonsteroidal antiinflammatory drugs (NSAIDs), and acetylsalicylic acid (aspirin) can irritate the mucosa.
INCORRECT. Although appropriate, performing hand hygiene would not be the initial step in preparing to perform a gastric occult blood test.
2. Why might the nurse delegate to nursing assistive personnel (NAP) the skill of performing a gastric occult blood test for a patient who has vomited?
- The task is easy to demonstrate to NAP.
- The likelihood of a positive result is minimal.
- This skill may be delegated if performed on vomited stomach contents.
- The agency trains NAP to perform only NG tube testing.
INCORRECT. The ease with which the nurse can teach NAP to do the task has no bearing on whether the skill of performing the test may be delegated.
INCORRECT. The probable result of the test has no bearing on whether the skill of performing the test may be delegated.
CORRECT. The skill of performing a Gastroccult test may be delegated to NAP only if the specimen is taken from stomach contents the patient has vomited. For example, NAP may obtain a specimen from the contents of the patient’s emesis basin.
INCORRECT. The level of training offered to NAP at the agency has no bearing on whether the skill of performing the test may be delegated.
3. Which statement best illustrates the nurse’s understanding of the role of nursing assistive personnel (NAP) in carrying out a gastric occult blood test for a patient with a low hemoglobin and hematocrit?
- “Have you used the new Gastroccult testing system?”
- “The next time the patient vomits, please test it for occult blood.”
- “Is the patient capable of assisting with the specimen collection?”
- “Remember to tell me the results of the test immediately.”
INCORRECT. Although appropriate, this is not the most relevant statement regarding the nurse’s understanding of the NAP’s role in carrying out the test.
CORRECT. This statement reflects the nurse’s understanding that NAP may perform the test only on emesis.
INCORRECT. Patients need not assist with specimen collection for this test.
INCORRECT. Although appropriate, this is not the most relevant statement regarding the nurse’s understanding of the NAP’s role in carrying out the test.
4. Which statement best illustrates correct interpretation of a positive gastric occult blood test?
- “We don’t need to retest the patient right now, because the sample turned green after about 60 seconds.”
- “If the test sample turns blue, it is positive for blood.”
- “The monitor area needs to turn blue within 30 seconds.”
- “Because it was positive, I notified the patient’s physician.”
INCORRECT. This statement indicates correct interpretation of a negative result, not a positive result.
CORRECT. This statement indicates an understanding that the sample is positive for blood if any traces of blue appear after 60 seconds.
INCORRECT. This statement indicates an understanding of proper technique, not correct interpretation.
INCORRECT. This statement indicates an understanding of proper reporting, not correct interpretation.
5. Which nursing action addresses the risk for infection related to gastric occult blood testing?
- Maintaining aseptic technique while handling the Gastroccult slide
- Performing the test in the patient’s bathroom
- Assessing the patient’s history of previous gastrointestinal (GI) bleeding
- Ensuring appropriate hand hygiene before and after testing
INCORRECT. It is not necessary to maintain aseptic technique while handling the Gastroccult slide.
INCORRECT. Although performing the test in the patient’s bathroom would not be inappropriate, other locations, such as the patient’s room or a utility room, would also be acceptable.
INCORRECT. Although assessing the patient’s history of previous GI bleeding is appropriate, it does not pertain to the risk for infection.
CORRECT. Ensuring appropriate hand hygiene is the most effective way of minimizing the risk for infection.
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