Tests – Laboratory

All outpatient laboratory services performed in the Richards Building during the following hours:

Monday – Friday, 7:00 AM – 6:00 PM
Saturday, 8:00 AM – 12:00 Noon

Laboratory Tests

Fasting means that you should not eat any foods for 12-14 hours. You should not drink any liquids, other than water, for 12-14 hours. Water will not interfere and you can drink any amount. However, no other liquid beverage can be taken. Not all lab tests require you to fast,. The ones requiring fasting have a bold “F” after the test on the laboratory order form. Tests you should be fasting for include:

  • any tests for fat or lipid testing (e.g. cholesterol, HDL, triglycerides, cardiac lipid panel)
  • homocysteine
  • lipid electrophoresis, fractionation
  • glucose ­ fasting, glucose tolerance tests (see Glucose Tolerance Test instructions)
  • other tests as requested and instructed by your physician

If you are being tested for a PT (prothrompin time for coumadin or blood thinning therapy ) you do not need to be fasting.

Most other tests do not require fasting and you can come in to be tested at any time regardless of what you have eaten or had to drink for that day.

The fecal fat test provides a means of measuring fecal fat for the diagnosis of steatorrhea. It requires a special diet of 100-150 grams of fat per day for 3 days before the test is started. Alcohol should be avoided for 24 hours before the test. Avoid the use of all laxatives. A recommended test diet prior to doing the test (for 3 days in a row) is the following:

  • 2 cups whole milk – 20 grams
  • 8 oz. lean meat or 5 oz. medium-fat meat – 24/25 grams
  • 1 egg – 5 grams
  • 5 servings fruits and vegetables – trace
  • 6 servings whole-grain breads or enriched breads or cereal – trace
  • 10 tsp fat(e.g. margarine, oil, mayonnaise)- 50 grams
  • Total fat: about 100 grams

Patient Instructions on Semen Analysis for Fertility Studies

Scheduling:

Semen analysis is performed Monday through Friday between 8:00 AM and 2:00 PM. No appointments are necessary. You must stop at the registration desk on the first floor to check in. Please bring your insurance information and the lab order slip with you.

Collecting the specimen:

If you live within an hour’s drive of the hospital, you may collect your specimen at home. If you live further away, you will need to collect at the hospital. Your partner may accompany you. Consider going to a friend’s house or hotel room if you think you will have difficulty collecting at the hospital.

The semen specimen should be collected in a sterile container (such as one designated for a urine sample), which you may obtain from the physician’s office or laboratory. Specimens collected in a condom will not be accepted. Prior to the test, abstain from sexual activity for a minimum of 24 to 48 hours but no more than 7-8 days. Abstinence makes collection easier and may have a positive affect on semen quality. Collect by masturbation only; no intercourse or oral sex. Fluids other than semen may affect the test results. The only acceptable lubricant is vegetable oil, because it does not contain perfumes or additives. We prefer that you not use one at all if possible. Collect close to the time that you plan to leave for the hospital. When transporting the specimen, place the container in a brown paper bag to protect it from light and take care to protect it from temperature extremes. In the cold months, carry the specimen inside your coat to keep it at body temperature. Never put it in the refrigerator or on a heater. Write your name, date of birth, collection date and time on the label.

Results:

Your physician will receive the results within 5-7 days. To discuss the results make an appointment with your physician.

1. Diet prior to having the test performed

  • It is recommended for three days prior to having the test performed that your diet must contain at least 150 grams of carbohydrate per day. If you are on an unusual diet that has a reduced amount of carbohydrates, you should add an additional two days to the diet that contains at least 150 grams of carbohydrates. If you are on a special diet or have not been eating well for a period of time you should discuss this with your doctor (inadequate food intake will invalidate the testing).
  • During the 12 hours prior to the day you are to have the test performed, you should fast. This means you should not have any food or drinks (other than water, avoiding even black coffee) for 12 hours. In addition, smoking and even mild exercise are not allowed.

2. What to expect on the day of the procedure

  • On arrival at the laboratory, the phlebotomist will draw your blood initially and have you collect a urine sample. This is a baseline level obtained while still fasting.
  • You will then be given an orange drink that contains a specific amount of glucose (this is a sugar substance).
  • The phlebotomist will then draw your blood at certain time intervals after having finished the orange drink and also have you collect more urine samples.
  • Depending on the doctor’s order (the tolerance test may be a 2-hour, 3-hour, or longer process) you will need to be in the lab or close by and should not be actively moving about. We recommend you bring reading materials, or some other quiet activity (e.g. knitting) for your length of stay during the testing.

There are other forms of testing similar to the traditional Glucose Tolerance Procedure that your doctor may have ordered. If you have any questions, please discuss it with your physician or call the hospital laboratory.

  1. A one-hour screening test: you follow the above procedures prior to testing. On the day of testing, you are given the orange drink and then drawn for a glucose level one hour after finishing the drink.
  2. A two-hour postprandial: you follow the above procedures prior to the day of testing. On the day of testing you have a breakfast that contains an adequate amount of carbohydrates and after 2 hours you are drawn for a glucose test.
  3. A fasting blood sugar (glucose) test – drawn after fasting for 12 hours.

The laboratory has a convenient “SWUBE” paddle to help you in the collection of the sample. This can be obtained at the doctor’s office or the Laboratory.

  1. Collection should be done a few hours after the patient has gone to sleep or immediately upon rising. Collect before washing or having a bowel (stool) movement.
  2. Remove the tube from the wrapper and pull on the plastic cap to remove the paddle from the tube (leave the paddle attached to the cap)
  3. The paddle has a sticky side and a smooth side. Separate the buttocks and press the sticky side against several areas of the rectal area.
  4. Replace the paddle in the tube, snapping the cap on securely.
  5. It is important to wash your hands at this point. Be careful not to contaminate the outside of the tube.
  6. Label the tube with name, date and time and place the tube in a plastic bag. Deliver promptly to the lab. If there is a delay, refrigerate the tube.

A sputum sample is material that is coughed up from the lungs. It is not “saliva” which are liquid secretions found in the mouth, or nasal secretions ­ these samples are not acceptable to culture. A sputum is best collected in the morning upon getting up from a reclining position or when a deep cough from the lungs can be produced. The sputum raised should be expelled into a sterile specimen cup that has been obtained from the doctor¹s office or lab. It should be brought to the lab within 1 hour.
Many parasites are intermittently passed in the stool. The best way to detect them is to examine specimens collected at least 1 day apart. Unless otherwise instructed by your physician, collect stool specimens every other day for a total of 2 to 3 specimens.

  1. Stool samples should be obtained before taking any medications, antacids, laxatives, barium or bismuth (including Pepto-bismal).
  2. Collect the stool in a wide mouth container, or on a plastic sheet placed over the toilet seat opening. DO NOT pass the specimen into the toilet or directly into collection vial. DO NOT mix urine or water with the sample.
  3. Open the vial(s) carefully, do not spill any of the fluid in the vial. Using the collection spoon attached to the vial cap, add enough stool until the liquid reaches the ARROW on the label and mix stool in fluid well. DO NOT MIX THE CAPS. Liquid, bloody, mucous, unformed stool specimens are good to test. Take portions from different parts of the stool if it is a formed specimen.
  4. Label the vials with name, date and time of collection.
  5. Store at room temperature until delivered to lab. When obtaining multiple specimens, if culture is ordered – collect the vial with the green cap last.

Specimen containers may be obtained from the doctors’ offices, or the laboratory. It is best when collecting samples for parasite testing or culture, that the stool be placed into the preservative immediately after collection.

The Specimen vial with the purple cap – is to test for parasites, and Giardia antigen testing.

The Specimen vial with the green cap – is for culture. If the physician has ordered a stool for C. difficile testing you need to collect a fresh sample as outlined above and place the sample in a specimen cup (with no preservative). This should be delivered to the lab within a few hours (or if there is to be a delay, it should be refrigerated).

This specimen may be collected in the physician’s office, at the hospital, or at home. If it is collected at home, a clean catch kit should first be obtained from the doctor’s office or hospital. A first voided morning urine (first urination after getting out of bed in the morning) should be obtained for best results. It is important to clean the urethral area and collect a midstream specimen (allow the first small amount of urine voided to go into the toilet, then collect the rest in the container). The specimen should then be delivered to the hospital within 1-2 hours. If there is a delay, it should be refrigerated (do not allow to freeze) for not more that 8 hours.

If the specimen is collected at the office or hospital you will be instructed on how to collect the specimen then.

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How to provide a “24-hour” urine specimen

Your physician has ordered test(s) that require a 24-hour urine collection. The accuracy of the test(s) is dependent upon how well you are able to collect the specimen. Following these instructions will help ensure the accuracy of the tests.

  1. Avoid alcoholic beverages, vitamins and other medications (if possible – check with your doctor before discontinuing any medications) for at least 24 hours before you start collecting the specimen and during the collection period.
  2. The specimen container may have a preservative in it. Do not dispose of the preservative and be sure to keep the container out of reach of children.
  3. Do not exceed your normal intake of liquids during the day before and the day of collection unless your physician gives you specific directions to do otherwise.
  4. The 24-hour collection period begins when you get up in the morning and empty your bladder. DO NOT COLLECT THIS URINE – THIS FIRST VOIDING OF THE DAY IS DISCARDED. It is important to record the time and date of this voiding on the specimen container label.
  5. For the next 24 hours ALL the urine samples that you void must be collected – day and night – until the final collection when you empty your bladder the next morning approximately 24 hours from the time marked on your specimen container. Include this last sample in the collection jug along with all the other samples.
  6. Keep the specimen container in a cool place; refrigerate if possible.
  7. Return the specimen to the lab as soon as possible after the last collection.