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TYPES OF URINE SPECIMEN

Type of Urine Specimen Purpose


Random Routine screening
First morning Routine screening, Pregnancy tests, Orthostatic
protein
Fasting (Second morning) Diabetic screening/monitoring
2-hour postprandial Diabetic monitoring
Glucose tolerance test Optional with blood samples in GTT
24-h (or timed) Quantitative chemical tests
Catheterized Bacterial culture
Midstream clean-catch Routine screening/ Bacterial culture
Suprapubic aspiration Bladder urine for bacterial culture and cytology
Random Urine Specimen
most commonly received
Ease of collection
Convenience for the patient
may be collected at any time and without prior patient
preparation
useful for routine screening test
affected by dietary intake or physical activity, or excessive
fluid intake
Random Clean Catch Urine
ideal for cytology studies
w/ prior hydration
instruct: 24-32 oz of water each hour for 2 hours
Cytologic protocols: for 3-5 consecutive days
First morning urine/ 8-hour specimen
ideal screening specimen
concentrated specimen
ideal to test subs. that require concentration or incubation for detection
prevents false-negative pregnancy tests
evaluating orthostatic proteinuria
Instructions:
the patient voids before going to bed
Immediately on rising: collect urine specimen
Delivered and tested within 2 hours
Fasting (Second Morning) Urine
double-voided urine
Instructions:
The first morning specimen is discarded (first void)
Urine is collected after half an hour without eating
anything (second void)
will not contain any metabolites from food ingested
before the beginning of the fasting period
2-hr postprandial urine
Instructions:
Empty the bladder
Consume a routine meal: 100 g carbohydrates
2 hours after meal completion: collect urine specimen
Ideally: a blood sample should also be drawn
Glucose tolerance urine specimen
collected to correspond with the blood samples drawn
during a GTT
fasting, half-hour after ingestion, 1-hour, 2-hour, 3-hour,
4-hour, 5-hour, 6-hour
tested for glucose and ketones
results are interpreted along with the blood test results
aid in interpreting the ability to metabolize a measured
amount of glucose
correlated with the renal threshold for glucose
24-hr (timed) urine
produce accurate quantitative results
many solutes exhibit diurnal variations
E.g. catecholamines, 17-hydroxysteroids, and electrolytes
lowest concentration: early morning
highest concentration: afternoon
24-hr urine
Instructions:
Day 1: 7 am:
Patient voids and discards specimen, collects all urine for the next
24hours
Day 2: 7 am:
Patient voids and add urine to the previously collected urine
24-hr urine
Urea Nitrogen
by-product of protein metabolism
indicator of kidney function
Urine electrolytes
Ca, Cl, K, Na
part of clinical work-up for suspected endocrine disorders or hormonal
imbalances or kidney dysfunction
Urine Ca: recurring kidney stone formation
17-hydroxysteroids
suspicion of Addisons disease
24-hr urine
Catecholamines
Breakdown products: Homovanillic acid (HVA), Vanillylmandelic acid
(VMA), normetanephrine, and metanephrine
adrenal gland tumor (pheochromocytoma) is suspected
symptomatic hypertension
Urine total protein
indicator of kidney damage
5-hydroxyindoleacetic acid (5-HIAA)
carcinoid tumor of the digestive tract
metabolite of serotonin
24-hr urine
Urine creatinine
breakdown product of creatine phosphate
cleared from the body exclusively by the kidneys
to screen for kidney dysfunction
creatinine clearance test
Catheterized urine
urine is collected by inserting a hollow tube (catheter) through the
urethra into the bladder
bacterial culture
UTIs are common in catheterized patients
Catheter threaded up the urethra, through the bladder and into
each ureter
to determine: one or both of the kidneys are involved in the disease
process
Suprapubic aspirate
puncturing of the abdominal wall and the distended
bladder
needle and syringe
principally for bacterial cultures
under normal conditions: bladder is sterile
completely free of extraneous contamination
anaerobic microbes
infants
specimen contamination is often unavoidable
Mid-stream clean catch urine
Routine UA and Urine culture
Instructions:
Cleanse the urethral opening and surrounding area with soap and water
Void into the toilet and continue to void, but interrupt the urine stream
Collect at least 30mL into a clean, dry, sterile, and leak-proof container
Finish voiding into the toilet
Label the specimen container with the following information:
Patients name, age, gender
Type of specimen
Date and time of collection