COLLECTING URINE

SPECIMEN

EIRENE JOY DEL MUNDO ALDAVE, RN

PURPOSE:

• Diagnose a urinary tract infection

(UTI).
• Identify the best antibiotic to treat
a urinary tract infection. This is
called sensitivity testing.
• Determine whether a urinary tract
infection has been cured.
URINARY SYSTEM
TYPES OF URINE COLLECTION

•CLEAN CATCH
•MID STREAM
•24 HOUR URINE
COLLECTION
Clean-catch midstream
urine collection
• This collection
method
prevents
contamination
of the sample.
 PROCEDURE
• Wash your hands to make sure they are
clean before collecting the urine.
• If the collection container has a lid, remove it
carefully and set it down with the inner surface up.
• Clean the area around your genitals.
– A man should retract the foreskin, if present, and clean
the head of his penis thoroughly with medicated
towelettes or swabs.
– A woman should spread open the folds of skin around her
vagina with one hand, then use her other hand to clean
the area around her vagina and urethra thoroughly with
medicated towelettes or swabs. She should wipe the area
from front to back to avoid contaminating the urethra with
bacteria from the anus.
• Begin urinating into the toilet or urinal. A
woman should continue holding apart the
folds of skin around the vagina while she is
urinating.

• After the urine has flowed for several

seconds, place the collection container in
the stream and collect about 2 fl oz (59
mL) of this “midstream” urine without
interrupting the flow.
• Avoid touching the rim of the container to
your genital area, and avoid getting toilet
paper, hair, feces, or menstrual blood in the
urine sample.
• Finish urinating into the toilet or urinal.
• Carefully replace the lid on the container.
Wash your hands. Return the urine sample
to the lab. If you are collecting the urine at
home and cannot get it to the lab within an
hour, refrigerate the sample. It can be
refrigerated for up to 24 hours. Follow the
instructions from your lab.
Collection and Preservation of
24-Hour Urine Specimens
• The 24-hour collection container may
contain chemicals (as a preservative) that
are hazardous. DO NOT urinate directly
into the container. Collect urine in a clean,
dry vessel and carefully pour the urine into
the 24-hour collection container.
PROCEDURE
• 1. Collect the specimen in one or more disposable,
wide-mouthed, clean plastic container(s) with a plastic
lid large enough to hold about 3 L.  Amber-colored
containers may be required for light-sensitive analytes.
• 2. Determine if the collection will require a
preservative, ensuring the collection container has the
appropriate preservative, at the correct concentration,
along with a warning label indicating the preservative
in use.
• 3. Label the collection container including the patient
identification (name and hospital number), test(s)
required, and preservative used. 
• 4. The start date and time plus the finish
date and time should be recorded on the
container and requisition at the beginning
and end of the collection period.
• 5. The 24-hour collection should begin by
having the patient empty his or her
bladder or catheter bag at a fixed time
and discard the specimen.  Record this
start date and time on the collection
container and on the laboratory
requisition.
• 6. If a preservative is required, the patient
must be advised to collect the urine in a
separate clean container and then
carefully transfer the urine to the
collection container that will be
transported to the laboratory.  Comment: 
Assume that all preservatives are
hazardous (most are).
• 7. Instruct the patient (or nurse) to collect
all voided urine during the 24-hour
collection period and add it to the
collection container.
• 8. The collection should end exactly 24
hours after it began, by having the patient
empty his or her bladder, or catheter bag,
and adding this specimen to the collection
container.
• 9. Record the ending date and time on the
collection container and on the laboratory
requisition.
• 10. Carefully seal the cap tightly so as to
avoid leakage.
PATIENT TEACHING FOR 24
HR URINE SPECIMEN
• 1. Follow your physician’s advice
regarding any food, drink or drugs
before and during collection.
• 2. Empty your bladder completely
upon awakening and discard this
urine. This is your start date and
time.  Write it on your paperwork
and/or the collection container.
• 3. Collect all urine for the next 24
hours.  The last urine collected should
be that voided upon awakening the
second day, at the same time as the
start time.
• 4. Recap the collection
container carefully and
completely.
• 5. Return the collection
container to where you were
instructed to return it as soon
as possible.
COLLECTING SPECIMEN FROM AN
INDWELLING CATHETER
 COLLECTION OF URINE FROM
INDWELLING CATHETER

•(A) First, use a swab moistened with an (B) Then insert the needle and withdraw
antiseptic to clean the area where the a specimen of urine. Standard
sterile needle will be introduced. precautions require that gloves be used
when contact with urine is probable.
WEE-WEE BAG
CATHETERIZATION
CATHETERS
PURPOSE OF CATHETERIZATION

• TO RELIEVE DISCOMFORT DUE TO

BLADDER DISTENTION OR TO PROVIDE
GRADUAL DECOMPRESSION OF THE
DISTENDED BLADDER.
• TO OBTAIN URINE SPECIMEN
• TO EMPTY THE BLADDER COMPLETELY
PRIOR TO SURGERY
• TO FACILITATE ACCURATE
MEASUREMENT OF URINARY OUTPUT
FOR CRITICALLY ILL CLIENTS WHOSE
OUTPUT NEEDS TO BE MONITORED
HOURLY.
• TO PROVIDE INTERMITENT OR
CONTINOUS BLADDER DRAINAGE AND
IRRIGATION
• TO PREVENT URINE FROM
CONTRACTING AN INCISION
AFTER PERINEAL SURGERY
• TO MANAGE INCONTINENCE
WHEN OTHER MEASURES HAVE
FAILED
PERFORMING URINARY
CATHETERIZATION (assessment)
1. DETERMINE THE MOST APPROPRIATE
METHOD OF CATHETERIZATION BASED ON
THE PURPOSE. SEE DOCTORS ORDER
2. USE STRAIGHT CATHERTER
1. WHEN ONLY A SPOT OF URINE IS NEEDED
2. THE AMOUNT OF RESIDUAL URINE IS MEASURED
3. IF TEMPORARY DECOMPRESSION/ EMPTYING OF
THE BLADDER IS REQUIRED
• USE AN INDWELLING CATHETER IF:
– BLADDER MUST REMAIN EMPTY OR
CONTINOUS URINE MEASUREMENT/
COLLECTION IS NEEDED
• ASSESS THE CLIENTS OVERALL
CONDITION. DETERMINE THE CLIENT’S
ABILITY TO COOPERATE.
• DETERMINE WHEN THE CLIENT HAS LAST
VOIDED OR CATHETERIZED
• PERCUSS THE BLADDER TO CHECK FOR
FULLNESS OR DISTENTION.
EQUIPMENTS
• STERILE CATHETER WITH THE APPROPRIATE SIZE
• PAIR OF STERILE GLOVES
• WATER PROOF DRAPE
• ANTISEPTIC SOLUTION
• COTTON BALLS
• FORCEP
• KY JELLY
• URINE RECEPTACLE
• SPECIMEN CONTAINER
EQUIPMENTS FOR AN
INDWELLING CATHETER
• ALL PREVIOUS MENTIONED
PLUS:
• SYRINGE FILLED W/ STERILE WATER IN AN AMT
SPECIFIED BY THE MANUFACTURER
• COLLECTION BAG AND TUBING
• DISPOSABLE CLEAN GLOVES
• SUPPLIES FOR PERINEAL CLEANSING
• DRAPE
• GOOSENECK LAMP
IMPLEMENTATION
• IDENTIFY YOUR CLIENT
• EXPLAIN THE PROCEDURE
• WASH HANDS
• PROVIDE CLIENT PRIVACY
• PLACE THE CLIENT IN AN APPROPRIATE
POSITION
• ESTABLISH ADEQUATE LIGHTING
• APPLY STERILE GLOVES
• SATURATE THE COTTON BALLS WITH
ANTISEPTIC SOLUTION
• ATTACH THE PREFILLED SYRINGE TO
THE INFLATION HUB AND TEST THE
BALLOON
• LUBRICATE THE CATHETER 1 TO 2
INCHES FOR FEMALES, 6-7 FOR MALES
• PERFORM PERINEAL CARE
• INSERT THE CATHETER FIRMLY 2-3 IN
FROM THE TIP. ASK THE CLIENT TO
TAKE SLOW DEEP BREATH AND
INSERT THE CATHETER AS THE
CLIENT EXHALES.
• ADVANCE THE CATHETER UNTIL
URINE STARTS TO FLOW THROUGH
IT.
• HOLD THE CATHETER W/ THE NON DOMINANT
HAND INFLATE THE BALLOON USING YOUR
DOMINANT HAND.
• PULL GENTLY THE CATHETER UNTIL
RESISTANCE IS FELT.
• FOR STRAIGHT CATH- MEASURE THE UO 750-
1000 ml IS EXPECTED TO BE DRAINED.
REMOVE THE STRAIGHT CATH WHEN THE
URINE FLOW STOPS.
• FOR AN INDWELLING CATHETER SECURE THE
CATHETER ON THE CLIENTS THIGH.
• ALSO SECURE THE COLLECTING TUBE TO BED
LINENS
• WIPE THE PERINEAL AREA WITH THE
REMAINING ANTISEPTIC OR LUBRICANT.
RETURN CLIENT IN A COMFORTABLE
POSITION.
• DISCARD ALL USED SUPPLIES IN
APPROPRIATE RECEPTACLES.
• DOCUMENT
PREPARE YOUR EQUIPMENTS
CYSTOCLYSIS

• CONTINUES BLADDER IRRIGATION

PURPOSE
> REDUCE BLEEDING AFTER SURGERY
> THROUGH VASOCONSTRICTION
CYSTOCLYSIS

• EQUIPMENTS
– Three-way Catheter set-up
– Irrigation fluid
– Urinary Drainage bag
– IV tubing
– Catheter Plug
• PERFORM CATHETERIZATION (IF CATHETER IS
NOT PRESENT)
• PREPARE THE EQUIPMENT
• WASH HANDS
• CONNECT THE IRRIGATION INFUSION TUBING
TO THE IRRIGATION SOLUTION
• APPLY CLEAN GLOVES AND CLEANSE THE PORT
WITH ASEPTIC TECHNIQUE
• CONNECT THE IRRIGATION TUBING TO THE
INPUT PORT OF THE THREE WAY CATHETER
• CONNECT THE DRAINAGE BAG IN THE
DRAINAGE PORT.
• REMOVE THE GLOVES AND IRRIGATE THE
BLADDER
IRRIGATE THE BLADDER

• FOR CONTINOUS IRRIGATION OPEN THE

FLOW CLAMP ON THE URINARY
DRAINAGE IF PRESENT.
• OPEN THE REGULATING CLAMP AND
REGULATE TO 40-60 DROPS PER MIN.
• ASSESS THE DRAINAGE FOR THE
AMOUNT I &O
IRRIGATE THE BLADDER

• FOR INTERMITTENT IRRIGATION,

DETERMINE WHETHER TH SOLUTION IS
TO REMAIN IN THE BLADDER FOR A
SPECIFIED TIME.
• ASSESS THE DRAINAGE FOR THE
AMOUNT COLOR AND CLARITY
• ASSESS CLIENT FOR DISCOMFORT
• DOCUMENT AND RECORD PROCEDURE
CATHETERS