Specimen collection: good-practice principles, Box 2. Collect the specimen in a clean, dry urine container. D. Female urine culture collection instructions: These are general instructions.BVH periodically changes the company which provides the mid-stream collection kits. A nurse caring for a group of patients in an ambulatory care clinic is collecting urine for several prescribed diagnostic tests. At 0700, a nurse obtains a capillary blood glucose result of 180 mg/dL from a patient who has diabetes mellitus. The clinical information obtained from a urine specimen is influenced by the collection method, timing and handling. Specimens must be collected at the right time, using the correct technique and equipment, and be delivered to the laboratory as quickly as possible (Dougherty and Lister, 2015). Appropriate containers include plastic disposable cups or bags (for infants) with a capacity of 50 ml. ). Collection 1. 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Which of the following should the nurse instruct the patient to avoid a few days before and during the testing period to reduce the risk of false-positive results? A: The patient just told me that he forgot to put the urine in the container. SPASU : Patient Preparation: 1. Specimens should be sent to the laboratory as soon as possible after collection as a delay may adversely affect the results. This procedure should be undertaken only after approved training, supervised practice and competency assessment, and should be carried out in accordance with local policies and protocols. Obtaining a specimen involves the collection of tissue or fluids for laboratory analysis or near-patient testing, and may be the first step in determining a diagnosis and treatment (Dougherty and Lister, 2015). In order to produce a meaningful laboratory test result, follow these instructions exactly. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for at least 96 hours. A clean-catch urine specimen is a sample of urine. Ask the patient to wash their hands with soap and water and dry them, to reduce the risk of the specimen being contaminated. Which of the following results should indicate to the nurse the presence of a UTI? However MSUs can become contaminated by: The aim of collecting MSUs is to reduce the effects of urethral contamination by taking a sample of urine while the bladder is emptying, avoiding the initial and end stages of micturition. Bring the specimen to the lab within 1 hour or collection or store refrigerated for up to 24 hours. Instructions to help patients with their test preparations or specimen collections. A vast assortment of collection and transport containers for urine specimens are available. Aware of their organisation’s policies and procedures for specimen collection; Able to explain the purpose of the specimen to the patient and the implication for treatment, and be able to obtain informed consent; Competent to undertake the procedure (Nursing and Midwifery Council, 2015) – this includes knowing the correct procedure for the collection, handling and transportation of the sample (Dougherty and Lister, 2015; RCN, 2012); Aware of standard infection prevention and control principles involved in the collection of tissue and body fluids (Box 2) (Loveday et al, 2014); Aware and understand the importance of accurate record keeping (NMC, 2015). Principle. The result of an MSU takes 2-7 days. Type. Specimen Volume: 4 mL. The procedure used to collect a specimen must minimise the risk of introducing error and protect the health and safety of both the patient and the staff who handle the sample. Timed urine collections may require the use of a chemical preservative or kept on ice or refrigerated during the duration of the collection. The collected urine should be added to the appropriate urine preservative tube or refrigerated immediately to retard growth of bacteria until the test is performed. You … Urine in the bladder is sterile and, in the absence of a UTI, it should not be contaminated with bacteria. Urine from the dependent drainage bag should not be used for a specimen, since it is not fresh and would not reflect accurate test results. A nurse caring for a patient who has diabetes mellitus is having difficulty obtaining a capillary fingerstick blood sample for point-of-care blood glucose testing. Measure and record this volume on the test request form and on the urine transport vial (see Pediatric Specimen Tubes below). Test name. Do not collect the first urine produced in the morning (first void). This helps to identify the causative organism and select appropriate antibiotics to treat the infection. While direct-observation collections provide specimens of the greatest credibility, non-witnessed collections can be effective if safeguards are in place to ensure the donor does not have access to substances which may affect test results (water, chemicals, substitute urine, etc. 2. Urine Cytology Your health care provider has requested a urine specimen. The patient can then void the remaining urine into the toilet. Wash your hands and put on gloves and an apron if you are accompanying the patient or handling the specimen. If the patient needs help, follow standard infection prevention and control precautions, and wear gloves and an apron (as a minimum) when collecting and handling the MSU. The first voided morning specimen is preferred. Specimen collection training . For which of the following tests is a random sample voided into a clean cup appropriate? Urine Specimens – an overview of collection methods, collection devices, specimen handling and transportation This Focus Topic is the first of a two part series on urine specimen collection. A nurse is caring for a patient who has a suspected UTI. When there is an immediate need to collect a specimen (e.g., a post -accident A urine protein test measures the amount of protein in urine. Determining which urine collection method and container should be used depends on the type of laboratory test ordered. When collecting a 24-hour urine specimen:What is done with the urine collected at 7 a.m. the last day? Urine samples are collected over a 24-hour period and sent to a lab for analysis. This test can be used to diagnose a kidney condition or see if a treatment is working. Using an incorrect container can affect the accuracy of results; for example, bacterial swabs contain a transport medium that is incompatible with viruses (Dougherty and Lister, 2015). 2. The final section is an exam. A: Administer insulin according to the patient's sliding scale orders. Good-practice principles for specimen collection are outlined in Box 1. During this procedure, the nurse should. Empty bladder completely on awakening in the morning and discard this urine specimen. High concentrations of gadolinium and iodine are known to interfere with most metals tests. Decide on a day to do the test when your child will be at home all day. Bacteria that colonise the distal urethra; Sterile container with a wide top to collect the urine, which can then be transferred into a specimen pot; Soap and water, 0.9% sodium chloride solution or a disinfectant-free solution for genital hygiene; Obtain informed consent and explain the procedure to optimise the quality of the specimen. Place the specimen and request form in the specimen bag. When collecting a 24-hour urine specimen:Where must the urine for a 24-hour specimen be stored? Before you start, you should have been provided with a sterile container for the collection of the urine. Disposable gloves and apron – additional  personal protective equipment (gown, mask/respirator, visor) may be required depending on the specimen; Sterile container appropriate for the specimen (consult local policies); Biohazard (high-risk) label indicating the danger of infection (Brekle and Hartley, 2014) if the patient is known or  suspected to have a Hazard Group 3 pathogen such as hepatitis B, hepatitis  C or HIV (Health and Safety Executive, 2003). To collect the urine sample: Keeping your labia spread open, urinate a small amount into the toilet bowl, then stop the flow of urine. These convenient online drug test specimen collection training modules consist of instruction and demonstrations, each followed by a quiz that will take approximately 15 minutes. A: Have the patient urinate a small amount of urine before starting the collection. 4.4. https://www.hopkinsmedicine.org/.../24hour-urine-collection Instruct male patients to keep the foreskin retracted and direct the first part of the urine void (15-30ml) into the toilet to wash away any bacteria colonising the distal end of the urethra (Dougherty and Lister, 2015) (Fig 2b). How to Collect the 24-hour Urine Specimen. Specimen pH should be between 4.5 and 8 and will stay in this range if kept refrigerated. Please state commencement and completion time of sample duration on collection … Please refer to the Test Directory for specific tests. Collecting tissue/body fluids: precautions to take. Show More about Collecting a Sterile Urine Specimen Residual urine, urine left in the bladder after voiding, can be measured at the time of catheterization. Collect all urine for the next 24 hours so that the morning urine void on the second day is the final collection. Hold the urine cup a few inches (or a few centimeters) from the urethra and urinate until the cup is about half full. Check whether the patient needs any help. Patients should wash and dry their hands before collecting an MSU; Dougherty and Lister (2015) also recommend that the urethral meatus is cleaned to further reduce the risk of contamination, although they acknowledge that the effectiveness of this intervention has been questioned. The types of urine sample you might be asked for include a random specimen, first morning specimen or timed collection. Complete the documentation on the specimen pot, request form and in the patient’s notes (2d). Urine specimens and children. Patients may find the procedure embarrassing and it is important to protect their privacy and dignity while offering or providing support. When a clean-catch urine specimen is required, follow the directions given under Urine for Culture in the Microbiology Specimens: Bacteriology and Mycobacteriology Specimens section. Collecting urine specimens is a job function of the Nursing Assistant. The validity of urine drug screen results is dependent on specimen integrity. In this way, you are collecting the urine from the bladder. Collection Instructions: 1. To collect a 24-hour urine specimen: Follow your physician’s directions regarding intake of food, drink, or drugs before and during collection. The patient should collect the middle part of the stream in a wide-neck sterile container without interrupting micturition (Dougherty and Lister, 2015) (Fig 2c). Inform the patient of the reason for specimen collection; Explain how long it will take for the results to be available and how the patient will receive them; Implications for care (Dougherty and Lister, 2015). 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