Cebu Doctors’ University

College of Nursing
Mandaue City, Cebu

NCM 104 - COMMUNITY HEALTH NURSING I:

Bag Technique and Urine

Testing

Group F2:
Reboquio, Brigette Mae
Salazar, Kim Annais
Saluta, Lance Andrei
Salvador, Genei Mae
Sosoban, Spica Rose
Solemne, Tanya Victoria
Tabelon, Sofia Danielle
Tanato, Sheena Kaye

Facilitator: Ms. Nikki Rae R. Cayanan

Date Submitted: August 24, 2022
 TABLE OF CONTENTS
BAG TECHNIQUE AND URINE TESTING PAGE

Learning Outcome for Bag Technique 3

CLO#1: Define and discuss the terms related to bag 4

technique

CLO#2: Give the importance of bag technique, nursing 5

bag or Public Health Nurse (PHN) bag, and home
visiting

CLO#3: Differentiate the types of family-nurse contact. 6

CLO#4: Discuss the different types of case load. 8

CLO#5: Make a plan of visit based on the available 9

data.

CLO#6: Identify the contents of the CHN bag. 13

CLO#7: Recognize the general guidelines in using the 16

CHN bag.

CLO#8: Explain the different principles in Bag 16

Technique.

Learning Outcome for Urine Testing 18

CLO#1: Define the terms related to urine testing 19

CLO#2: Discuss the importance of urine testing. 21

CLO#3: Identify the factors influencing urination. 21

CLO#4: Explain principles involved in urine testing. 21

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CLO#5: Compare the characteristics of normal and 22
abnormal urine and cite possible causes of
abnormalities.

CLO#6: Identify the common urinary problems and 23

causes.

CLO#7: Explain the different ways of specimen 24

collection and test.

CLO#8: State the different method of urine testing. 26

CLO#9: Enumerate nursing responsibilities before, 28

during and after urine testing.

References 30

2
LEARNING OUTCOMES:

After 9 hours of class reporting and various online class activities, the level II
nursing students will be able to:

BAG TECHNIQUE

CLO#1:Define and discuss the terms

CLO#2:Give the importance of bag technique, nursing bag or Public Health Nurse
(PHN) bag, and home visiting
CLO#3:Differentiate the types of family-nurse contact.
CLO#4:Discuss the different types of caseload.
CLO#5:Make a plan of visit based on the available data.
CLO#6:Identify the contents of the CHN bag.
CLO#7:Recognize the general guidelines in using the CHN bag.
CLO#8:Explain the different principles in Bag Technique.
CLO#9: Demonstrate beginning skills in arranging contents of CHN bag and
performing bag technique

3
CLO#1: DEFINE AND DISCUSS THE TERMS RELATED TO BAG TECHNIQUE

1.1 Bag Technique- is a tool used by nurses to deliver nursing procedures efficiently
during visits and provide effective patient care to clients across the lifespan.

1.2 Plan of visit- a tool that has to be prepared beforehand to be able to identify
client needs to achieve the desired outcomes.

1.3 Home Visit- refers to the practice wherein the nurse assesses the patient’s home,
environment, and family condition during the visit to identify healthcare needs and
provide nursing care services.

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1.4 Family-Nurse Contact- this is when the client's family and the nurse discuss
health goals through the delivery of appropriate nursing care.

1.5 Community Health Bag- serves as a vehicle for carrying the materials and
equipment needed during home visits.

1.6 Case Load - refers to the number and kind of cases handled by the health care
nurse in a particular period

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CLO#2: GIVE THE IMPORTANCE OF BAG TECHNIQUE, NURSING BAG OR
PUBLIC HEALTH NURSE (PHN) BAG, AND HOME VISITING

Bag Technique

● Promotes minimal or total prevention of the spread of infection during exposure

to the community.
● Contributes to efficiency and safety during the execution of procedures.
● Provides a systematic arrangement of materials in the bag rendering quick
identification of specific materials.
● Saves time and energy during the conduct of procedures.
● Allows the nurse to provide effective nursing care.

Public Health Nurse Bag

● Stores needed supplies and medication to provide care to individuals and families
within the community.
● Establishes the urgency for hand hygiene and other measures to prevent the
spread of infection.
● Cultivates a nurse’s preparedness when engaging with the community.
● Allows the nurse to provide safe and efficient care during home and community
visits.

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Home Visiting

● Allows the nurse to have an immediate assessment of the family.

● Allows the nurse to scope family needs, including neglected ones.
● Provides data that is essential in creating interventions specific for the family.
● Allows the nurse to observe and evaluate the progress and effectiveness of the
interventions employed for a particular family.

CLO#3: DIFFERENTIATE THE TYPES OF FAMILY-NURSE CONTACT

❖ Types of family-nurse contact

● Clinic visit
- This type of family-nurse contact is one where the family member visits a private
clinic, health center, barangay health station or in an ambulatory clinic to seek aid
from professional health workers.

● Group conference
- A group conference is a family-nurse contact that allows families and members of
each family to share experiences and practical solutions to common health
concerns, such as a conference of mothers in the neighborhood, which may be
held at a health facility or within the community.

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● Telephone
- This family-nurse contact utilizes mobile or cell phone communication services so
that the nurse and the family can reach each other.

● Written communication
- Written Communication is a one-way method of giving specific information to
families such as instructions given to parents through school children.

● Home visit
- This family-nurse contact is one where the nurse goes to the family and
interaction between the nurse and family takes place in the client’s/family’s
residence.

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CLO#4: DISCUSS THE DIFFERENT TYPES OF CASELOAD

● Health Supervision - a type of case load wherein the spacing of visit is based on
needs and principles that teaching is more effective in the learning period are at
frequent intervals. Recipient is the family and their recognized needs. Aggregate:
children, elderly, mothers. Patients may be well or sick.

● Post-Partum - a medical condition that many women get after having a baby. It’s
strong feelings of sadness, anxiety (worry) and tiredness that last for a long time after
giving birth. These feelings can make it hard for you to take care of yourself and your
baby. PPD can happen any time after childbirth. It often starts within 1 to 3 weeks of
having a baby. It needs treatment to get better.

● Ante-Partum - it means “before childbirth.” Antepartum depression happens only

during pregnancy. It's also sometimes called maternal depression, prenatal depression,
and perinatal depression.

● Morbid - a client has an established or diagnosed illness.

● Case Finding - finding out possible illness of the patient and wherein the nurse will
assess, study the history of, note signs and symptoms of any of the patient.

● Geriatric - refers to medical care for older adults, an age group that is not easy to
define precisely. Gerontology is the study of aging, including biologic, sociologic, and
psychological changes.
● Mental Health - Our emotional, psychological, and social well-being all contribute to
our mental health. It has an impact on how we think, feel, and act. It also influences
how we deal with stress, interact with others, and make healthy choices.

CLO#5: MAKE A PLAN OF VISIT BASED ON THE AVAILABLE DATA

Situation: Student nurse, Dan Zabala, visited Barangay San Isidro. In the community,
he met with the Fernandez family. It was Mr. and Mrs. Fernandez, together with their
1-week old newborn.

Name of family: Fernandez Date of Visit: Aug. 19, 2022

Address: Brgy San Isidro, Ormoc City Type of Case: Case Finding

Plan of Visit No.: 1

General objectives:
The family will be able to gain knowledge, an attitude, and abilities in health
development and the prevention of illness after 1 week of student nurse-family
interaction.

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Specific outcomes:
After 30-45 minutes of student nurse-client orientation, the family will be able to:
1. Establish rapport with the nurse.
2. Define home visit.
3. Discuss the importance of the house visit and its purpose.
4. Observe the family's behavior and the environment.
5. List any potential environmental health issues.
6. Create an effective nursing intervention based on the indicated health issues.

Nursing Actions:
1. Establish rapport with student nurses.
• Greet and introduce yourself.
• Ask names of the family members.
2. Define home visit.
• A home visit is when a nurse goes to a family's home to use a variety of tools to
diagnose various health issues.
3. Discuss the importance of the house visit and its purpose.
• To recognize health issues and requirements
• Prevent the spread of infection/illness
• Promote the nurse-family relationship
4. Observe the family's behavior and the environment.
• Observe the environment
• Ask them about any health issues that they and their family members frequently deal
with.
• Be concerned about their behavior and environment.
5. List any potential environmental health issues.
• Conduct nursing interviews with the family.
• To identify prospective and existing problems, use family evaluation tools like the
Initial Database (IDB) and the Family Coping Index (FCI).
6.Create an effective nursing intervention based on the indicated health issues.
7. Set another contact of visit
• Secure the details:
o date
o place
o time

Name of family: Fernandez Date of Visit:Aug. 19, 2020

Address: Brgy San Isidro, Ormoc City Type of Case: Post-partum
Client: Mrs. Fernandez

Plan of Visit No.: 2

General objectives:
The family will be able to gain knowledge, an attitude, and abilities in health
development and the prevention of illness after 1 week of student nurse-family
interaction.
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Specific outcomes:
After 30-45 minutes of student nurse-client orientation, the mother will be able to:

1. Describe incision pain from a scale of 1 – 10, with 10 as the highest and 1 as the
lowest
2. Follow pharmacological regimen
3. Verbalize non pharmacological methods for pain relief
4. Dress wound properly
5. Set another contact of visit
• Secure the details:
o date
o place
o time

Nursing Actions:
1. Identify the pathophysiological and psychological causes of pain and record their
responses.
• The postpartum incision after a cesarean birth causes pain.
2. Gather the client's or significant other's assessment of the pain, paying particular
attention to its location, features, onset, duration, frequency, quality, and intensity.
• Ask client using COLDSPA
3.Based on the client's knowledge of and acceptance of the treatments that are offered,
develop pain management.
• Ask about the physician's prescription and go over the recommended dosage with the
client.
4. Explain nonpharmacologic measures on pain management.
• Dressing wound properly
• Keeping body alignment and using proper body mechanics
• Resting between activities to reduce occurrence of pain.
5. Set another contact of visit
• Secure the details:
o date
o place
o time

Name of family: Fernandez Date of Visit: Aug. 19, 2022

Address: Brgy San Isidro, Ormoc City Type of Case: Post-partum
Client: Mrs. Fernandez

Plan of Visit No.: 3

General objectives:
The mother will be able to manage her pain through pharmaceutical and
non-pharmacologic measures after 1 week of the student nurse-family connection.

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Specific outcomes:
After 30-45 minutes of student nurse-client orientation, the mother will be able to:
1. Report if pain is relieved or controlled
2. Verbalize the nonpharmacologic measures for pain relief
3. Demonstrate use of relaxation skills for individual situation
4. Verbalize sense of control of response to acute pain

Nursing Actions:
1. Acknowledge the client's description of their pain.
2. Explain about any additional important methods that may help clients manage their
pain.
3. Identify changes in pain characteristics.
4. Provide health teaching.
• Ensure that the medication schedule is followed.
• Encourage the client to go to a physician or barangay health center if the pain is
intolerable.

CONTENTS OF A PLAN OF VISIT

1. Demographic Data - information on groups of individuals based on characteristics

like age, sex, and place of residence. It may consist of socioeconomic elements like
profession, family status, or income.

2. General Objective - it is the final result/long-term objective. Planning that

incorporates short-term goals outlines the immediate outcomes anticipated from actions
already in motion. These goals emphasize regular activities.

3. Specific Objectives – define the outcomes in terms of knowledge, skill, and

attitude; participant performance, as opposed to trainer performance or instructional
procedure - anticipated performance change; short-term.

4. Nursing Actions – are the actions a nurse takes to carry out their plan of care for a
patient, including any treatments, procedures, or teaching opportunities aimed at
enhancing the patient's comfort and health.
5. SOAPIE Documentation - a thorough system for gathering and arranging data on
patients that takes into account both their experiences and the specifics of their care.
Each area of the chart is identified by the abbreviation SOAPIE, which stands for
Subjective. Objective. Assessment. Plan. Implementation. Evaluation.

Example:

SOAPIE 1 (SOAPIE DOCUMENTATION OF POV 1)

S: The family introduced themselves, including their age and how long have they been
married. The husband is Mr. Zach Fernandez and his wife is Mrs. Kyla Fernandez, with
their son, Mr. Zeke Fernandez, a 1-week old newborn.

O: The family had enough space for the three of them.

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A: Readiness for enhanced family processes

P: After 1 week of nursing care, the family will express their feelings freely and
appropriately.

I: Assist the family in improving interactions.

E: The family demonstrated individual involvement in problem-solving to improve family

process.

SOAPIE 2 (SOAPIE DOCUMENTATION OF POV 2)

S: The client verbalized a pain score of 8 out of 10 and described her incision pain as,
“mura mag ma gisi akong tiyan, lisod kaayo ihigda”

O: The client showed limited and guarded movements with facial grimace as she
moved. Upon assessing vital signs, T = 37.1 degree Celsius, P = 75 bpm, R = 17 bpm
and BP = 100/80

A: Acute pain: facial grimace related to post-partum incision

P: After 1 week of nursing care, the client will be able to relieve pain and verbalize a
pain score of 3 out of 10.

I: Review pharmacologic pain regimen and discuss nonpharmacologic management for

pain relief.

E: The client relieved pain and verbalized a pain score of 5 out of 10.

SOAPIE 3 (SOAPIE DOCUMENTATION 3)

S: The client verbalized a pain score of 3 out of 10.

O: The client showed less guarded movements and can now carry her newborn longer
than before.

A: Acute pain: facial grimace related to postpartum incision.

P: After 1 week of nursing care, the client will be able to relieve pain and verbalize a
pain score of 3 out of 10.

I: Taught the client and her family how to dress the wound and encouraged client to
minimize extreme movements. The client was also able to rest as prescribed by the
physician, pain relief medications were taken by the client.

E: The client verbalized a pain score of 3 out 10.

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CLO#6: IDENTIFY THE CONTENTS OF THE CHN BAG

The nursing bag usually has the following:

Articles for infection control:

● Soap in a covered dish

- A platform where a bar of soap can be drain and keep the bar soap dry
● Linen or disposable paper towels
- It protects the bag from getting wet and/or contaminated
● Apron
- A protective garment worn over the front of a nurse's uniform
● Bottles of antiseptics and hand sanitizer
- Used to kill or destroy microorganisms and/or inactivate viruses

(source:google)

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Articles for assessment of family members:

● Body thermometer(s)
- Used to check client’s temperature
● Measuring tape
- A flexible ruler that is used to measure the size of patients' waist, hips,
neck, chest, thigh circumference and a range of other measurements
- Spring balance
- Used to determine the weigh the new-born to give their birth-weight
● Portable diagnostic aids
- Used to diagnose or monitor disease inside and outside of healthcare
setting such as glucometer (if available) or benedict’s test
● Benedict’s test
- Used to check for the presence of reducing sugars
● Benedict’s solution
- (Fehling's solution) is used in detecting of simple sugars such as glucose.
It's a clear blue solution made up of copper sulfate, sodium citrate, and
sodium carbonate
● Medicine dropper
- Used to distribute small amount of liquids
● Test tube
- Used to hold and mix or store materials for use in experiments and research
● Test tube holder
- Used for holding a test tube in place or when the tube is hot and cannot be
touched.
● Alcohol lamp (with denatured alcohol)
- Alcohol burner or spirit lamp is a piece of laboratory equipment used to
produce an open flame

(source:google)

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Sterile items:

● Dressing
- Protect the wound from bacteria in the environment and absorb drainage
● Cotton balls
- Used in medical field including cleaning out wounds
● Cotton tip applicators
- Used to clean the swabs, for first-aid applications when applying ointments
to wounds and collecting specimen
● Syringes (2 and 5 ml) with needles
- Used to inject fluid into, or withdraw fluid from the body
● Surgical gloves
- Used to protect the wearer and/or the patient from the spread of infection or
illness during medical procedures and examinations.
● Cord clamp
● Used to seal umbilical cord, preventing loss of blood as cord dries beneath
it
● Surgical scissors
- Used for cutting sutures and dissecting biological tissue
● Kelly curved
- Used to clamp blood vessels and hold heavy tissues in place
● Kelly Straight (pick-up forceps)
- Used to clamp off blood vessels, remove small root tips and grasp loose
objects
● Kidney basin (dressing forceps)
- Used in medical and surgical wards to receive soiled dressings and other
medical waste
● Ear Syringe
- Used to remove wet or very soft wax that has collected on the eardrum

(source:google)

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 Clean articles:

● Adhesive tape
- Used to attach bandages, gauze, and other dressings to skin around
wounds
● Bandage scissors
- Used for sizing dressings and removing circumferential bandages

(source:google)

CLO#7: RECOGNIZE THE GENERAL GUIDELINES IN USING THE CHN BAG

1. Hands should be washed as often as possible to reduce contamination of the bag and
its contents.
2. The CHN bag should contain all the necessary articles and equipment which may
be used to answer all emergency needs.
3. Bag contents must be protected from contact with various non-sterile objects.
4. Remove all jewelry.
5. Greeting the patient and his or her family.
6. To maximize efficiency and prevent confusion, the contents of the bag should be
organized in a way that is most convenient for the users.
7. Depending on the policies, different bag techniques should be used.
8.When carrying the bag, it is advised to avoid swaying or shaking it.
9. After use, the bag needs to be carefully cleaned and disinfected, especially if there is
a communicable case nearby.
10.Wash and clean equipment after the procedure.
11.Do aftercare

CLO#8: EXPLAIN THE DIFFERENT PRINCIPLES IN BAG TECHNIQUE

● Microbiology

The bag and its materials and equipment should be thoroughly cleaned and
disinfected or sterilized after use, especially if there is a communicable case
in the area. The nurse must also perform medical handwashing as frequently
as the situation necessitates so as to avoid contaminating the bag and its
contents.

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 The proper use of the bag technique helps the nurse in infection control. The
proper use of the bag allows the practice of medical aseptic technique during
the home visit where the family members are considered potential sources of
infection.

● Time and Energy

The nurse must possess sufficient knowledge on the location of specific

items in the bag in order to save time and energy during any procedure and
avoid confusion.

● Psychology

The bag technique promotes organizing skills of nurses.This in turn enables

the nurse to perform a nursing procedure with ease and deftness. The bag
technique demonstrates the effectiveness of the overall care provided by the
nurse to an individual or family.

● Sociology

The bag technique demonstrates competency of the nurse which promotes

nurse-client relationship.This in turn provides assurance and comfort to the
client throughout a procedure.

● Pharmacology

The nurse must be knowledgeable and be familiar with the different

solutions and disinfectants found within the bag, such as betadine, which
used in wound healing.

● Body Mechanics

The nurse must also avoid swinging the bag so as to not jeopardize the
arrangements of the bag’s contents. If the nurse is unbalanced, he or she
may fall, thus compromising the bag’s stability.

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LEARNING OUTCOMES:

After 9 hours of class reporting and various online class activities, the level II
nursing students will be able to:

URINE TESTING

CLO#1: Define the terms related to urine testing:

CLO#2: Discuss the importance of urine testing.
CLO#3: Identify the factors influencing urination.
CLO#4: Explain principles involved in urine testing.
CLO#5: Compare the characteristics of normal and abnormal urine and cite possible
causes of abnormalities.
CLO#6: Identify the common urinary problems and causes
CLO#7: Explain the different ways of specimen collection
CLO#8: State the different method of urine testing
CLO#9: Enumerate nursing responsibilities before, during, and after urine testing

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CLO#1: DEFINE THE TERMS RELATED TO URINE TESTING

● Urine
- It is a liquid by-product of metabolism containing water and waste
products.

● Urine testing
- It is commonly known as “urinalysis”. It is used to detect and manage
complications and abnormalities in the urine.

● Enuresis
- It is most frequently known as “bed-wetting”. It is the involuntary
urination by individuals who don’t have full bladder control, especially
children.

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● Diuretics
- It is also called as “water pill”. It is a medicine that is designed to
stimulate the flow of urine by increasing the amount of water and salt
expelled from the body.

● Ketone bodies
- These are substances produced in the liver during gluconeogenesis
that serves as an energy source when glucose is low.

● Hematuria
- It is the presence of blood in urine. The most common cause is UTI.

● Uric acid
- It is a product of the metabolic breakdown of purine nucleotides.

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CLO#2: DISCUSS THE IMPORTANCE OF URINE TESTING
● To detect possible diseases in early stages.
● To determine a client’s level of hydration.
● To monitor the status of a certain health condition you’re receiving treatment
for, such as diabetes or kidney disease.
● To check the functionality of the urinary system.
● To determine the urine alkalinity and acidity.
● To analyze the content and chemical makeup of a client’s urine.

CLO#3: IDENTIFY THE FACTORS INFLUENCING URINATION

● Growth and Development

Urinary defects caused by incomplete growth and development
include hypospadias, defects in the renal pelvis and renal agenesis.

● Psychosocial
Stress, anxiety and other negative emotions affect the urination of an
individual.

● Fluid and Food intake

Inadequate fluid intake, most especially water and malnutrition
obscure the urinating pattern.

● Medication
Some components in certain prescribed medications may increase the
frequency and color of urination.

● Muscle Tone and Activity

The bladder walls contain detrusor muscles.

● Surgical and Diagnostic Procedures or Examinations

Certain diagnostic procedures

● Personal Habits
Unhealthy habits can lead to further complications.

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CLO#4: EXPLAIN PRINCIPLES INVOLVED IN URINE TESTING

● Anatomy and Physiology

The urinary bladder serves as a temporary reservoir that contains the

urine output.

● Microbiology

Proper sanitation and sterility must be observed when handling urine

output and other bodily secretions.

● Time and Energy

Urine samples for testing must be sent in within an hour.

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 ● Psychology
Elated feelings may alter the frequency of urination when testing.

● Sociology
Urine samples must be obtained by the medical professional from the
patient with confidentiality and proper manners.

● Chemistry

The use of Benedict’s solution in urine testing helps determine the

amount of sugar in the urine.

● Body Mechanics

Proper body mechanics affect the muscles in the bladder when

urinating.

CLO#5: COMPARE THE CHARACTERISTICS OF NORMAL AND ABNORMAL

URINE AND CITE POSSIBLE CAUSES OF ABNORMALITIES

Characteristics Normal Urine Abnormal Urine

Color; Clarity The color of normal Atypically colored urine

urine ranges from pale may have red, orange,
yellow to deep gold. blue, green, or brown

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 tints.

Odor; Volume Odorless or has a slightly Sweet fruity odor, “maple

“nutty” odor. syrup” odor, and very bad
odor.

pH; Specific Gravity Adults' normal results Abnormal results are

range from 1.010 to typically those that are
1.020. less than 1.010 or
greater than 1.020.

Presence of: Ketones, Ketones are excreted in High ketone levels in

Glucose, Proteins, your urine and blood. A urine may be a sign that
Blood small amount of ketones your body is too acidic.
in your body is normal. This condition is called
ketoacidosis.

CLO#6: IDENTIFY THE COMMON URINARY PROBLEMS AND CAUSES

Common Signs, Symptoms Causes

Urinary
Problems

Dysuria ● pain and/or burning, ● urinary tract infections or

stinging, or itching urethritis, pyelonephritis,
sensation at the start, prostatitis, vaginitis, and
during, or after sexually transmitted
urination diseases
● foreign body or stone in
the urinary tract, trauma,
benign prostatic
hypertrophy, and tumors

Glycosuria ● urine sample shows ● diabetes mellitus,

more than 0.25mg/ml of pregnancy,
glucose hyperthyroidism,
high-sugar diet, renal
disease

Hematuria ● presence of blood in ● UTI, kidney infections,

urine kidney stone, bleeding in
● frequent, painful the urinary tract due to
urination trauma

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Oliguria ● urine output that is less ● dehydration, obstruction,
than 1 mL/kg/h in kidney disease
infants, less than 0.5
mL/kg/h in children, and
less than 400 mL daily
in adults

Polyuria ● more than 2.5 liters of ● Diabetes mellitus, taking

urine per day diuretics, kidney disease or
● dehydration failure, liver disease,
Cushing’s syndrome

Urinary Frequency ● the need to urinate ● UTI, Changes in muscles,

many times during the nerves or other tissues
day, at night (nocturia), affecting bladder function
or both but in normal or
less-than-normal
volumes.

Nocturia ● Excessive urination at ● UTI, pregnancy, diabetes,

night bladder obstruction, high
water intake just before
bedtime

● have trouble starting to ● bladder obstructions, an

Urinary Hesitancy urinate or maintaining enlarged prostate, and
urine flow complications related to
childbirth

Urinary Retention ● inability to completely ● blockage, medications,

empty the bladder of nerve issues, infections,
urine swelling
● severe abdominal pain

Proteinuria ● more than 150 ● glomerulonephritis,

milligrams of protein in amyloidosis, kidney stones
urine
● foamy, bubbly urine
● edema in feet, belly,
face

Urinary ● urine leaks when ● overactive bladder

Incontinence sneezing, laughing, muscles, weakened pelvic
coughing, exercising, floor muscles, nerve
etc damage that affects
● sudden, intense urge to bladder control, UTI
urinate followed by an

26
 involuntary loss of urine.

Urinary Tract ● Pain or burning while ● When bacteria enter the

Infection urinating urinary tract through the
● Frequent urination urethra and begin to
● Feeling the need to multiply in the bladder
urinate despite having
an empty bladder.
● Bloody urine.
● Pressure or cramping in
the groin or lower
abdomen.

CLO#7: EXPLAIN THE DIFFERENT WAYS OF SPECIMEN COLLECTION

● Random specimen

- For chemical and microscopic examination, a voided specimen is

usually more suitable. A randomly collected specimen may be collected
at unspecified times and is often more convenient for the patient. A
random specimen is suitable for most screening purposes.

● First morning specimen or 8-hour specimen

- The patient should be instructed to collect the specimen immediately

upon rising from a night’s sleep. Other 8-hour periods may be used to
accommodate insomniacs, night-shift workers, and in certain pediatric
situations. The bladder is emptied before lying down and the specimen
is collected on arising so that the urine collected only reflects the
recumbent position. Any urine voided during the night should be
collected and pooled with the first morning voided specimen.

● Fasting specimen

- This differs from a first morning specimen by being the second voided
specimen after a period of fasting.

● 2-Hour postprandial specimen

- The patient should be instructed to void shortly before consuming a

routine meal and to collect a specimen 2 hours after eating.

● 24-hour (or timed) specimen

- To obtain an accurately timed specimen, it is necessary to begin and

end the collection period with an empty bladder. The following
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 instructions for collecting a 24-hour specimen can be applied to any
timed collection (consult test requirements to determine if a special
preservative is required):

○ Day 1 – 7 AM: Patient voids and discards specimen. Patient

collects all urine for the next 24 hours.

○ Day 2 – 7 AM: Patient voids and adds this urine to the

previously collected urine.

● Catheterized specimen

- This specimen is collected under sterile conditions by passing a hollow

tube through the urethra into the bladder.

● Midstream “clean catch” specimen

- This specimen provides a safer, less traumatic method for obtaining

urine for bacterial culture. It also offers a more representative and less
contaminated specimen for microscopic analysis than the random
specimen. Adequate cleansing materials and a sterile container must
be provided for the patient.

● Suprapubic aspiration

- Urine may be collected by external introduction of a needle into the

bladder. It is free of extraneous contamination and may be used for
cytologic examination.

● Pediatric specimens

- This may be a sterile specimen obtained by catheterization or by

suprapubic aspiration. The random specimen may be collected by
attaching a soft, clear plastic bag with adhesive to the general area of
both boys and girls.

CLO#8: STATE THE DIFFERENT METHOD OF URINE TESTING

Urinalysis - A laboratory test on urine which involves checking its appearance,

concentration, and content. It is performed to detect and manage a wide range of
disorders, such as urinary tract infections, kidney disease and diabetes.

● Visual Exam (24-hour Urine Collection)

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 - Urine is collected over 24 hours to provide your healthcare provider a
clearer picture of your overall renal function, including output and
composition.

● Dipstick Method (Rapid Analysis)

- A special strip (dipstick) is used to test for substances in the urine

sample. The chemical strips change color if certain substances are
present or if their levels are above typical levels. A dipstick test checks
for the following:

Acidity The pH level indicates the amount of acid in urine. The pH

level might indicate a kidney or urinary tract disorder.

Concentration A measure of concentration shows how concentrated the

particles are in your urine. A higher than normal
concentration often is a result of not drinking enough fluids.

Protein Low levels of protein in urine are typical. Small increases in

protein in urine usually aren't a cause for concern, but larger
amounts might indicate a kidney problem

Sugar The amount of sugar (glucose) in urine is typically too low

to be detected. Any detection of sugar on this test usually
calls for follow-up testing for diabetes

Ketones As with sugar, any amount of ketones detected in your urine

could be a sign of diabetes and requires follow-up testing

Bilirubin A product of red blood cell breakdown. Usually, bilirubin is

carried in the blood and passes into your liver, where it's
removed and becomes part of bile. Bilirubin in your urine
might indicate liver damage or disease.

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Evidence of Either nitrites or leukocyte esterase — a product of white
infection blood cells — in your urine might indicate a urinary tract
infection.

Blood Blood in your urine requires additional testing. It may be a

sign of kidney damage, infection, kidney or bladder stones,
kidney or bladder cancer, or blood disorders.

● Microscopic (Complete Urinalysis)

- Performed in a lab to assess the physical, chemical, and microscopic

characteristics of your urine.

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CLO#9: ENUMERATE THE NURSING RESPONSIBILITIES BEFORE,
DURING, AND AFTER URINE TESTING

BEFORE

● Prepare all the needed materials in the procedure

● Perform medical handwashing
● Provide and verify the label of the urine specimen's sterile container.
● Make sure to explain the procedure to the client
● Before beginning the collection procedure, instruct the client to wash
their hands
● Inform the client on how to collect sterile urine specimen from
midstream
● Make sure to wear gloves when collecting the specimen
● It should be noted that the sample was collected

DURING

● Inform the patient to thoroughly clean the urethral area with a cotton ball
or towelette to prevent outer bacteria from getting into the specimen.
● Allow the client confidentiality
● Allow the patient to urinate into the container
● Acquire a urine specimen in accordance with the guidelines
● Cover the whole specimens securely, classify the specimen container with
patient information, and send to the lab as soon as possible

AFTER

● Do medical hand washing

● Properly discard all the materials that being used
● Note down the procedure and report any significant findings
● Perform after care

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 LIST OF REFERENCES:

1. Cleveland Clinic. Urinalysis: What It Is, Purpose, Types, and Results.

https://my.clevelandclinic.org/health/diagnostics/17893-urinalysis

2. Community Bag. (n.d.). Nurseinfo. Retrieved from

https://nurseinfo.in/community-bag/

3. Konlan, K. D., & et al. (2021, March 24). The Practice of Home Visiting by Community
Health Nurses as a Primary Healthcare Intervention in a Low-Income Rural Setting: A
Descriptive Cross-Sectional Study in the Adaklu District of the

4. Mushoo, S. (3434). CHN Bag. Scribd. https://www.scribd.com/doc/47836314/CHN-Bag

5. Nies, M. A., & McEwen, M. (2019). Community and Public Health Nursing (E. F.
R. Sumile, Ed.; 2nd ed.). Elsevier.

6. R. (2017, July 4). Bag Technique. RNpedia. https://www.rnpedia.com/nursing-

notes/community-health-nursing-notes/bag-technique/
7.
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8. Safe Caseloads in the District Nursing Service. (n.d.). QNIHeritage. Retrieve
from https://www.qni.org.uk/nursing-in-the-community/district-nurse- caseloads/

9. Vera, M. B. (2015, August 12). Bag Technique in Nursing. Nurseslabs.

https://nurseslabs.com/home-visits-bag-technique/

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