URINE COLLECTION (URINE SPECIMEN BY MIDSTREAM CATCH)

Definition: It is a method of obtaining a urine sample to be sent for various tests including routine analysis and urine culture or other urine tests that require uncontaminated urine for accurate results. Clean-catch or midstream catch is preferred type of specimen for culture and sensitivity testing because of the reduced incidence of cellular and microbial contamination. Purposes: To determine bacteremia, in addition to protein, glucose and ketones in pregnant woman. Equipment: Soap and water Sterile bottle Implementation ACTION 1. 2. 3. 4. 5. 6. Identify the patient. Explain the urine collection procedure to the patient. Provide a specimen container and instructions on how to cleanse the genitalia and collect the urine. Provide equipment for cleaning genitalia before patient urinates. Instruct the client to keep labia majora separated while urinating. For midstream urine, instruct women to void little urine in the toilet then catch 30-50 cc of midstream urine directly to sterile bottle. RATIONALE This is done to ensure that you perform the procedure to the right patient. Explanation encourages patients cooperation and reduces apprehension. This ensures that urine will be placed on sterile container. Preparation enhances efficiency and decreases possibility of contamination. This is done to avoid any fecal matter to flow with urine. The first flow of urine washes microorganisms and debris from the urinary tract. Collecting the specimen midstream ensure a sterile specimen is obtained. Capping of the container prevents inadvertent spilling and possible contamination of the specimen. This eliminates error. This is done to avoid alteration of the results. Urinalysis may be altered if the specimen is more than one hour old. It decreases the transmission of microorganisms. Documentation serves as legal record. It allows continuity of care to patient for any abnormal results.

7.

Clean the outside of the container and cover.

8. 9.

Label specimen properly. Perform test promptly

10. Clean all use equipment. 11. Record time, type of examination.

HEAT AND ACETIC ACID TEST

Definition: A test used to detect presence of protein in urine. Proteins in urine are coagulated by heat and the degree of coagulation is directly proportional to the amount of protein present. Purposes: To detect presence of protein in urine To help evaluate and monitor kidney function To help detect and diagnose early kidney damage and disease Equipment: Acetic acid Alcohol lamp Test tube Implementation ACTION 1. 2. 3. 4. Identify the patient. Explain the procedure to the patient Wash hands Prepare the needed equipments. RATIONALE This is done to ensure that you perform the procedure to the right patient. Explanation encourages patients cooperation and reduces apprehension. This reduces the risk of transmission of infection. Having necessary supplies readily at hand enhances organization and efficiency in performing the test. It protects the nurse from coming in contact with body secretions. This prevents contamination of urine specimen. This prevents contamination of urine specimen. A fresh, concentrated voided urine specimen should be used. The first morning urine is usually sufficiently concentrated. This is done to avoid forming a precipitate. Too much heating the lower portion may result in exploding of test tube. Cloudy urine is often due to phosphate precipitation in alkaline urine. The phosphates and carbonates are redissolved when acetic acid is added and provided optimum pH.

5. 6. 7. 8.

Don gloves Follow strict standard precautions in obtaining specimen. Collect the specimen in sterile container. Fill the test tube 2/3 of clear urine.

9.

Heat the upper third of the test tube. Lower portion is not heated to serve as control.

10. If cloud forms, add few drops of 5%acetic acid.

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Heat again and allow cooling Read the result after 5 minutes. Dispose the used equipments. Remove gloves Wash hands Document the result.

To have more accurate result. It deters the spread of microorganism. It deters the spread of microorganism. Documentation serves as legal record. It allows continuity of care to patient for any abnormal results.

BENEDICTS TEST
Definition: A test used to detect presence of reducing sugars such as glucose, lactose and fructose, but not sucrose in a solution. Benedicts reagent is a solution of copper sulfate, sodium hydroxide and tartoic acid. Aqueous glucose is mixed with Benedicts reagent and heated. The reaction reduces the blue copper ion to form a brick red precipitate of copper oxide. Purpose: To detect presence of glucose in urine that is an indication of Diabetes Mellitus Equipment: Benedict Solution Alcohol lamp Test tube Implementation ACTION Identify the patient. Explain the procedure to the patient Wash hands Prepare the needed equipment. RATIONALE This is done to ensure that you perform the procedure to the right patient. Explanation encourages patients cooperation and reduces apprehension. This reduces the risk of transmission of infection. Having necessary supplies readily at hand enhances organization and efficiency in performing the test. It protects the nurse from coming in contact with body secretions. This prevents contamination of urine specimen. This prevents contamination of urine specimen. Benedicts reagent is used to detect the presence of sugar in the urine. If its color changes, the solution is contaminated. The sugars that may occur in the urine (glucose, fructose, galactose, lactose, sucrose and xyloketose) can be distinguished as the basis of the tests. This is done to ensure accurate results.

1. 2. 3. 4.

5. 6. 7. 8. 9. 10.

Don gloves Follow strict standard precautions in obtaining specimen. Collect the specimen in sterile container. Place 5 cc of Benedicts solution in a clear test tube. Heat the upper third of the test tube. If color changes, discard. Add 8-10 drops of urine and mix thoroughly.

11. 12.

Boil for several minutes (at least 2 minutes) Allow to cool and interpret the result.

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INTERPRETATION

a. BLUE (-) = no sugar present

The sensitivity of the test is approximately 50-80 mg of glucose/ 100 ml. A negative benedicts test corresponds to this color. It is usually equivalent to less than 50 mg/ 100 ml of reducing sugar. The interpretation of green reaction is therefore difficult and it is recommended as slightly trace. It is usually equivalent to 115- 550 mg/100 ml of reducing sugar. It is usually equivalent to 1400-2000 mg/ml of reducing sugar that is present, wherein the moderate amount is recommended. More that 200mg/ 1000 ml of reducing sugar is present; this is the bulk of the positivity of Benedicts test. It deters the spread of microorganism. It deters the spread of microorganism. Documentation serves as legal record. It allows continuity of care to patient for any abnormal results.

b. GREEN (+) = slightly trace

c. YELLOW (++) = trace

d. ORANGE (+++) = moderate amount

e. RED (++++) = large amount 14. 15. 16. 17. Dispose the used equipments. Remove gloves Wash hands. Document the result.