In all the chapters the Case Studies represent situations similar to those that the medical assistant may encounter in daily practice. Students are encouraged to consider the case study as they read each chapter.

As a medical assistant, you are performing reagent chemical strip analyses on patient specimens when you discover a specimen that is more than two hours old and has been sitting at room temperature during this time. When you remove the lid from the container, the odor very evident to you is ammonia-like and foul. The chemical strip indicates positive protein, positive nitrite, and positive bacteria. The microscopic analysis reveals 4+ bacteria but no evidence of white blood cells.

As you read this chapter, consider the following questions:

1. What is the maximum length of time that a urine specimen should be left at room temperature? If analysis cannot be performed within that maximum length of time, how should the specimen be handled?

2. An ammonia-like or foul odor associated with a specimen ordinarily indicates what condition or disease?

3. Does the chemical analysis confirm your suspicion associated with the odor?

4. Given the circumstances, can you trust the results on this specimen?