A nurse is caring for a client who needs to collect a midstream urine specimen

Collection and Preservation of 24-Hour Urine Specimens

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The 24-hour collection container may contain chemicals (as a preservative) that are hazardous.

. Collect urine in a clean, dry vessel and carefully pour the urine into the 24-hour collection container.

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.

NOTE:  Some urine tests require that the 24-hour urine collection be refrigerated during collection.   Follow your physician’s instructions for all collection procedures.

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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.

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Department of Nursing Services and Patient Care policies:

• Section XII Renal Standards
• Policy #N-12.030 - Urine Collection: Midstream Clean Catch
• Policy #N-12.032 - Urine Collection: Twenty-Four Hour

Pathology Laboratory Services Handbook:

• Urine Tests Requiring no Preservatives
• Urine Tests Requiring Preservatives or Special Containers
• Urine Tests Requiring Preservatives or Special Containers (Grouped by Tests)

An assistive personnel (AP) is collecting a 24-hour urine specimen from a patient. Which of the following statements by the AP indicates that the specimen collection will have to be restarted?

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• What is the most important action the nurse can take to ensure that a midstream urine specimen?
• When collecting a 24
• Which is the reason why urine is collected using the midstream method quizlet?
• For what type of testing is a clean

1. "The patient just told me that he forgot to put the urine in the container."
2. “The patient just voided into the toilet, so the next void can be collected."
3. "I have the container in a plastic bucket filled with ice."
4. "I used a container from the lab that has a preservative in it."

1. "The patient just told me that he forgot to put the urine in the container."

If the patient urinates and discards the urine, the timing of the specimen must begin again with the next urination.

2

A nurse is collecting a blood specimen for culture from a patient hospitalized for pneumonia. During this procedure, the nurse should.

1. rub the patient's arm at the selected site prior to venipuncture.
2. elevate the patient's arm above heart level for the venipuncture.
3. puncture the selected vein while the antiseptic solution is still visible on the skin
4. .keep the tourniquet in place from selection of the vein to completion of the collection.

.Stroking the arm from the distal area to the proximal area below the proposed site can help dilate the vein, but vigorous rubbing should be avoided due to the potential for injury.

3

A nurse is caring for a female patient who needs to collect a midstream urine specimen. Which of the following actions should the nurse take?

1. Have the patient urinate a small amount of urine before starting the collection.
2. Give the patient a clean urine cup from the laboratory.
3. Instruct the patient to cleanse the perineal area from back to front.
4. Tell the patient to collect about 10 mL of urine.

.Urinating a small amount before the collection helps cleanse the urethral meatus of any bacteria that may be present.

4

A nurse caring for a group of patients in an ambulatory care clinic is collecting urine for several prescribed diagnostic tests. For which of the following tests is a random sample voided into a clean cup appropriate?

1. Routine urinalysis
2. Urine culture and sensitivity
3. Urine creatinine clearance
4. Urine pregnancy testing

Routine urinalysis can be done on a random clean voided specimen collected during normal voiding into a clean urine cup.

5

A nurse is caring for a patient who has stage III pressure ulcer int he sacral area. Which of the following actions should the nurse take when obtaining a wound culture specimen from the pressure ulcer?

1. Wipe the crusty area around the outside of the wound with a sterile swab.
2. Irrigate the wound with an antiseptic solution before collecting the specimen.
3. Rotate a sterile swab in the area of drainage.
4. Collect drainage from the wound dressing.

.Rotating a swab in the center of the wound base to collect drainage is the appropriate technique for collecting a specimen for wound culture. It is important to avoid the wound’s edges when collecting the specimen.

6

At 0700, a nurse obtains a capillary blood glucose result of 18 mg/dL from a patient who has diabetes mellitus. Which of the following is a correct action for the nurse to take?

1. Administer insulin according to the patient's sliding scale orders.
2. Give the patient a glass of orange juice.
3. Encourage the patient to get up and exercise.
4. Repeat the test using a different glucometer.

A reading above the expected range warrants following the provider’s orders for sliding scale insulin based on the specific result..

7

A nurse for a patient who has diabetes mellitus is having difficulty obtaining a capillary fingerstick blood sample for point-out-care glucose testing. To help increase blood flow to the finger, the nurse should

1. wrap the finger in a warm cloth.
2. elevate the hand on a pillow.
3. pierce the skin in the middle of the finger pad.
4. firmly milk the puncture site.

.Heat helps increase blood flow to the area to be punctured.

8

A nurse is instructing a patient regarding collection of stool specimens for fecal blood testing. Which of the following should the nurse instruct the patient to avoid a few days before and during the testing period to help reduce the risk of false-positive results?

1. Vitamin E supplements
2. Calcium supplements
3. Poultry
4. Yogurt

1. Poultry

Red meat, poultry, seafood, and some raw vegetables can cause false-positive fecal occult blood testing results.

9

A nurse is teaching a patient about home collection of a stool speciment for fecal occult blood testing. Which of the following instructions should the nurse provide?

1. Eat a diet low in fiber and residue.
2. Obtain specimens from three different stools.
3. Refrigerate the specimen card after obtaining the first sample.
4. Avoid foods that are high in fat.

The three specimens must be taken from three separate, consecutive bowel movements.

10

A nurse is caring for a patient who has a suspected urinary tract infection (UTI). Which of the following urinalysis results should indicate to the nurse the presence of a UTI?

pH of 6.0

Trace amount of protein

Specific gravity of 1.010

1. WBC count of 8,000/mm3

.A white blood cell count above the expected reference range of 0 to 4,000/mm3 indicates urinary tract infection.

What is the most important action the nurse can take to ensure that a midstream urine specimen?

What is the most important action the nurse can take to ensure that a midstream urine specimen does not become contaminated? Ensure that the patient's perineum has been cleansed before the specimen is obtained.

When collecting a 24

A clean-catch, midstream specimen is the middle portion of urination, collected after the patient has completed a thorough cleansing procedure. Why does urine concentration vary during a 24-hour period?

Which is the reason why urine is collected using the midstream method quizlet?

After the cleaning, the patient starts voiding, and then continues voiding into the sample container. This midstream collection helps to ensure that the sample is without any contaminants. The patient is undergoing a 24-hour urine collection for creatinine clearance.

For what type of testing is a clean

A clean-catch urine specimen is a sample of urine. It is necessary when your health care provider wants to test your urine for bacteria, which may be causing an infection in your urinary tract. A clean-catch specimen is a way of collecting urine that does not contain a lot of bacteria from the skin.