TYPES OF URINE SPECIMEN

RANDOM SPECIMEN
 Most commonly received specimen
 May be collected anytime but the time of actual voiding must be indicated on the container
 Used for _______________
 May show erroneous results due to dietary intake and physical activity prior to collection

FIRST MORNING SPECIMEN (8-hour specimen)

 Ideal screening specimen
 Used to prevent ___________________ and for evaluating _______________
 It is a concentrated specimen assuring the detection of chemicals and formed elements that may not be present
in dilute random specimen.

FASTING SPECIMEN (Second morning)

 Second voided urine after a period of ________
 Does not contain any metabolites from food ingested before the beginning of fasting period.
 It is recommended for _______________

2- Hour Postprandial Specimen

 Patient is instructed to void shortly before consuming a routine meal and collect a specimen 2 hours after eating
 Specimen is tested for glucose, the results are primarily used for monitoring ____________ in persons with
diabetes mellitus
 Results can be compared with those of fasting specimen and blood glucose tests

GLUCOSE TOLERANCE SPECIMENS

 Sometimes collected to correspond with the blood samples drawn during a blood glucose tolerance test
 GTTs may include fasting, half hour, 1-hour,2-hour,3-hour specimens and possibly 4-hour,5-hour and 6-hour
specimens
 The urine is tested for glucose and ________ and the results are reported along with the blood test results as an
aid in interpreting the patient’s ability to metabolize a measured amount of glucose and are correlated with the
____________ of glucose.

24-Hour Specimen (Timed)

 Used to produces accurate quantitation of chemicals in the urine
 Used when the concentration of the substance to be measured changes with _____________ (E.g.
catecholamines, 17-hyrdroxysteroids and electrolytes), daily activities such as exercise, meals and metabolism
 Timed collections usually 12 or 24-hours eliminate the need to determine when excretion is optimal
 Can be divided into two types:
1. Collection for a predetermined time (2h, 12h, 24h) E.g. A 4-h or 12-h specimen for determination of urine
albumin, creatinine and albumin-creatinine ratio can be collected anytime and is an ideal specimen for screening
______________.
2. Collection during a specific time. E.g. 2-hour collection for the determination of urinary ____________ is
preferably collected from _________.
 To obtain an accurate timed specimen, the patient must begin and end the collection period with an empty
bladder.
 The concentration of a substance in a particular period must be calculated from the urine volume produced
during that time.
  Addition of urine formed before the start of collection period or failure to include urine produced at the end of
collection period will produce inaccurate results.
CONSIDERATIONS:
 Preservation of specimen collected over extended periods
 All specimens must be refrigerated or kept on ice during collection period and may also require the use
of additional preservative. (Preservative must not interfere with the tests to be performed)
 Appropriate information is included with test procedures and should be read before issuing a container
and instructions to the patient.

CATHETERIZED SPECIMEN
 Collected under ________ conditions by passing a catheter though the urethra into the bladder
 Most commonly requested test on a catheterized specimen is a _____________
 If routine urinalysis is also requested, the culture should be performed first to prevent contamination

MIDSTREAM CLEAN CATCH SPECIMEN

 Provides a safer less traumatic method for obtaining urine for bacterial culture and routine urinalysis
 Provides a specimen that is less contaminated by ____________ and ________ therefore, is more
representative of the actual urine than the routinely voided specimen
 Male patients should clean the glans, which begins at the urethra, and withdraw the foreskin if necessary
 Female patients should separate the labia and clean the urinary meatus and surrounding are.
 First part of the urine is _________, second part is voided in a sterile container and the last part is voided in
the toilet

SUPRAPUBIC ASPIRATION
 Urine is collected by external introduction of a needle through the abdomen into the bladder
 Because the bladder is sterile in normal conditions, suprapubic aspiration provides a sample for ________
culture that is completely free of extraneous materials.
 Specimen can be used for _________ examinations

PROSTATITIS SPECIMEN
 Three-glass collection procedure is used to determine prostatic infection
1st urine passed-
2nd urine passed-
3rd urine passed-
 Quantitative cultures are performed on all specimens, ___ and ___ specimens are examined
microscopically
 If the patient is suffering from prostatic infection the 3 rd specimen will have a ________/hpf and a
________count ____ greater than the 1 st specimen
 The second specimen is used as ________ for bladder and kidney infection. If it is positive the result of
the third tube is invalid and indicates that infected urine has contaminated the specimen

 Stamey-Mears four-glass localization procedure

VB1-
VB2-
EPS(Expressed prostatic secretions)
VB3-
 VB1 is tested for _______ infection
 VB2 is tested for _______ infection
 Prostatic secretions are cultured and examined for WBCs
  More than _______ white blood cells per HPF is considered abnormal
 Pre massage and post massage test (PPMT)
 A midstream clean catch urine specimen is collected
 A second urine sample is collected after a prostate massage
 Positive result is bacteriuria in the post massage specimen greater than 10x the pre massage count

PEDIATRIC SPECIMEN
 Made out of soft, clear plastic bags with hypoallergenic skin adhesive to attach to the genital area of both boys
and girls
 Specimens for culture may also be obtained using a clean-catch cleansing procedure and a sterile collection bag

DRUG SPECIMEN COLLECTION

 Collection of urine is the most vulnerable part of drug-testing program
 Correct collection procedures and documentation are necessary to ensure that the results produced belong to
the individual who submitted the specimen
CHAIN OF CUSTODY-

 Urine specimen collections may be “witnessed” or “unwitnessed”

Witnessed collection- indicated when it is suspected that the donor may alter or substitute the specimen or it is
the order of the client ordering the test. If a witnessed collection is ordered, a same gender collector will
observe the collection of _______ of urine.
 The urine temperature must be taken within ________ from the time of collection
 The temperature should read within the range of ___________
 If the temperature is not within range, the temperature should be recorded and the supervisor or employer
should be contacted immediately
 Recollection as soon as possible will be necessary