Question

A 42-year-old male patient has had a frequent productive cough and has been febrile for 3 days. The patient returned today from a long business trip, flying on four different airplanes over the past 5 days. He states he was sitting next to a small child on the last leg of the flight who sneezed continuously and that since that time has felt a mild sore throat and headache and has had this cough. The nurse is instructing the patient in the collection of a sputum specimen.

1. Identify the clinical problem(s) in the case study.
2. The patient is eager to provide the sputum specimen but states he needs first to rinse his mouth with mouthwash because he came directly to the clinic from the airport. The patient is concerned that his lack of oral hygiene today will influence the test results. How should the nurse respond to this patient?
3. The nurse washes her hands and hands the patient a sputum cup. The patient successfully expectorates sputum into the cup and, when complete, hands the cup to the nurse. There is some sputum on the side of the cup; the nurse wipes this with a tissue and begins to label the sample. Are there concerns regarding the nurse’s handling of the specimen?

Answer 1

1.Respiratory tract infections can be spread to one to another person in flight due to many factors such as decrease in partial pressure, remaining of air volume, recirculation of air mainly negative air flow. There is a chance of getting respiratory infection mainly pneumonia, COVID 19

These are spread by the air borne infections and droplet infections

PNEUMONIA SIGNS AND SYMPTOMS: Fever, sore throat, productive cough following after dry cough, headache, fever, shaking chills its incubation period may be varying from 2 to 4 weeks

COVID 19: signs and symptoms: fever, sore throat, productive cough, headache. Its incubation period from 1 to 12 or 14 days. Roughly 5 to 6 days

Acute bronchitis: fever, sore throat, productive cough, headache. It has incubation period of four to six day

2. The sputum culture is obtained after instructing the patient to perform mouth wash with warm water in order to reduce e contamination. so, Nurse can explain him to use mouth gargle with warm water before test. because, mouth wash solution contains antibiotic that is chlorahexidine that affect or kill bacteria in the sample. there fore, explain him not to use the chlora hexidine solution before taking sputum culture sample. Sputum specimen should be taken before consumption of food that is, on empty stomach in the morning. Because the lung secretions can be stagnated in the morning sputum which can be easily obtained. There is a chance of contamination of food particles in the sputum if the patient consuem food, there fore,advice him not to consume  food before giving sputum culture.

3. The nurse handles the sputum incorrect way. Before giving sputum cup to the patient, label the sputum cup with patient identification details and explain the patient how to cough up sputum to sputum cup that is collecting sputum into the sputum container and Ask the patient to close lid of sputum cup tightly and keep the sputum container in the plastic tray or given plastic bag. the errors of the nurse are: 1.Sputum container labels has not been written by the nurse. 2.The nurse gave no explanation regarding collection procedures of  sputum sampleto the patient before giving sputum to the patient. Otherwise these happened errors have not occurred. 3.After cleaning and labeling the sputum, there is a chance of cross transmission of infection. it has been suggested  this nurse should use protective personal equipment while handling sputum specimen. she can clean sputum with a disposible tissue paper after wearing personal protective equipments and dispose it in biomedical waste bag