Introduction: A number of diagnostic tests are available to evaluate the status of the urinary system.

During diagnostic testing, the nurse has many roles. The nurse maybe directly involved in collecting and testing specimens and in assisting the examiner during certain procedures. And as a nurse, we must be able to use test results appropriately in the patient’s care plan. Nurses are responsible for collecting urine specimens for a variety of tests. Some tests require clean voided specimens, some require sterile specimens. When handling body fluid, the nurse should wear gloves and take care not to contaminate other objects with the specimen. Care should also be exercised to see that the specimen is not contaminated with feces, menstrual blood, and so forth during the collection. OBJECTIVES At the end of this lecture the student be able: • • To identify different methods of urine collection. To effectively perform/follow the procedure when obtaining a urine sample.

Methods of Urine Collection 1. First Morning Specimen • • • most concentrated bladder is incubated Best for nitrate, protein, pregnancy tests, microscopic examination and routine screening. 2. Random Specimen • • • most convenient collected anytime good for chemical screening, routine screening, microscopic examination.

3. Midstream (Clean-Catch) • the external meatus is first cleansed with soap and water
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Discard the first void. and note the time. use a sterilized bedpan to collect the specimen. the time frame collection. the test ordered and other pertinent information. Post-Prandial • • used for glucose determination. URINE COLLECTION Page 2 . Timed 24-hour volume • • • • known also as 24-urine collection / 24 hours creatinine clearance all urine saved for 24-hour period it evaluates kidney function accurately. voids about 30ml into the toilet). 3. Add the urine from this last voiding to the specimen in the container. 5. diabetic monitoring collected 2 hours after meal. Mark the time the test begins and the time the collection should end in the container. then the client voids into the specimen container • the last urine in the bladder is also discarded. Ask the patient to void for 24 hours after the first voiding. Ask the patient to void at the beginning of urine specimen collection. to conclude the collection. If the client cannot void into the container.• Caution the client to hold the specimen container near.g. the meatus • Client voids and discard a little urine ( e. but not touching.. 5. Timed 2-hour volume • used for urobilinogen determination b. for measurement of total urine protein. 4. a. Collect all urine voided over the 24 hours into a large container and label it with the patients name. creatinine and electrolytes over a 24-hour period. 2. PROCEDURE: 1. 4. TIMED – requires collection of a certain time.

Observe standard precautions when handling urine specimen. A routine urinalysis requires at least 10ml Clinical Alert: 1. Storage: Refrigerate the collection bottle immediately after the patient has voided or place it on iced container. 4. insert the sterile needle. Women should always have a clean catch specimen if microscopic examination is to be done. 3. Use sterile disposable container. Cover all specimens tightly. not the collecting bag. URINE COLLECTION Page 3 . NOTE: Because patient may not always be able to void on request. the last specimen should be obtained as closely as possible to the stated end-timed of the test. A urine culture requires about 3ml of urine b. 5. aspirate the urine. 2. 6. Inform the patient about the collection. Catheter Specimen a. label properly and send immediately to the laboratory. using the special port for withdrawing urine Wear disposable gloves and use a sterile 21-25 gauge needle and syringe specimen container If no urine is found in the tube below the collection port. and transfer the specimen in the container. a. Sterile Specimen from Indwelling Catheter • • • • the specimen should be withdrawn from the catheter.6. Straight Catheterization • client is catheterized only to obtain sample of urine for testing • sterile catheterization technique is used and the catheter is removed immediately • least likely to be contaminated by bacteria from the perineum. clamp the tube briefly (for <30 minutes) Clean the port with an antiseptic swab. b.

PROCEDURE AND TECHNIQUES FOR COLLECTING URINE SPECIMENS 1. 3. never take a specimen from the client’s room without first labeling it. b. 4. Take care that the specimen is properly identified. (e.. failure to follow instructions in urine collection. it should be refrigerated or have an appropriate preservative added. menstrual blood flow d. URINE COLLECTION Page 4 . Tell the client to discard toilet tissue in the toilet or a waste bag rather than in the bedpan. Urine decompose when left at room temperature over time.g. Find out from the laboratory whether a preservative is needed for 24-hour specimens. Advise clients to void in the urine receptacle and defacate in the toilet.clean it with a disinfectant. If the outside of a container has been contaminated with urine. Take care not to contaminate other objects with urine. wear gloves. urine contaminated with feces. If specimen cannot be delivered immediately to the laboratory or tested within 1 hour. 5. 2.or refrigerate them. Assess for interfering factors like: a. Laboratory analysis is difficut if there is paper in the specimen. attach them securely to the container before leaving the client’s room.6. or at least place a piece of tape on the container and write the client’s name. Transport specimens to the lab promptly. Be sure that the specimen label and the laboratory requisition have the correct and identical information. vaginal discharge c. place lids tightly on containersto prevent spilling and contamination of other objects). Urine specimen must be free of fecal contamination. or to collect the urine specimen at a time when they dot also need to defecate.

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