Urine Specimen Collection

Definition

The urine specimen collection is a procedure used to obtain a sample of urine from a patient. The sample is used for diagnostic tests.

Purpose

The purpose of obtaining a urine sample is to test for any abnormalities that may be present, such as bacteria, ketones, or drugs.

Precautions

The skin of the genital area should be cleansed with a mild disinfectant to prevent contamination of the urine specimen or irritation of the delicate membranes of the area.

Description

A urine specimen is sometimes called a clean-catch, urine culture, or midstream specimen of urine, and is a method of collecting a quantity of urine for testing.

Preparation

The procedure and the reasons for it are explained to the patient. Able patients may be allowed to collect the urine sample, following the guidelines explained by the nurse.

Nurses who collect the urine sample should be sure to wash and dry their hands carefully. The items required for the procedure are as follows:

• a sterile urine cup for children and adults
• a sterile urine bag for infants
• a bedpan or urinal for patients unable to use the toilet
• sterile swabs
• sterile towels
• sterile gloves

For females, the area around the vulva is wiped and dried thoroughly with the sterile swabs and towels, working from front to back, with the nurse wearing sterile gloves. If the patient is unable to use the toilet, the bedpan is placed beneath her. When the urine begins to flow, the first part is allowed to pass into the toilet or bedpan. Then the sterile container is placed in position and filled with the mid-stream portion of the urine. The remainder of the urine is then allowed to pass into the toilet or bedpan. The lid is placed securely on the cup.

For males, the area around the penis and urethra is wiped and dried thoroughly with the sterile swabs and towels, working from front to back, with the nurse wearing sterile gloves. If the patient is uncircumcised, the foreskin should be held back during the complete procedure to prevent the skin contaminating the sample. The patient then begins to pass urine into the toilet or a urinal. Then, the sterile container is placed in position and filled with the midstream portion of the urine, taking care that the penis does not touch the sides of the container. The remainder of the urine is then allowed to pass into the toilet or urinal. The lid is placed securely on the cup.

For infants, the genitals are cleansed and dried thoroughly using the sterile wipes and towels. A sterile urine collection bag is placed over the area, with the adhesive tape firmly stuck onto the baby's skin. A fresh diaper is put on the child over the collecting bag and checked frequently for the child having passed urine into the bag. When the specimen is obtained, it is poured into a sterile container and sent immediately for testing.

Aftercare

The patient should be made comfortable.

All swabs, towels, and gloves should be disposed of in appropriate containers. The nurse should again wash and dry the hands thoroughly.

The specimen should be sent for testing as quickly as possible. Speed in testing the sample is essential in order to obtain an accurate result.

Complications

If there is a delay in sending the specimen for testing, some organisms present in the urine may die while others multiply, resulting in a false reading.

Patients should inform medical staff of any medications currently being taken as elements of the drugs may be present in the urine.

Results

Normal urine is free from bacteria and is a clear, amber color. It is slightly acidic.

Health care team roles

The nurse should be aware of the qualities of normal urine, and note if the patient has any difficulties in passing urine.

KEY TERMS

Genitals— The reproductive organs.

Ketones— Substances that are present in the blood and urine and occur in large amounts in diseases such as diabetes.

Membrane— A thin layer of tissue lining a part of the body.

Urethra— The tube through which urine flows from the bladder to the outside genitalia.

Vulva— The visible external female genitalia.

Resources

ORGANIZATIONS

American Nurses Association. 600 Maryland Ave. SW, Suite 100 West, Washington, DC 20024. (202) 651-7000. 〈http://www.ana.org〉.

OTHER

"Urine Culture: Clean—Catch." Medline Medical Encyclopedia. National Library of Medicine Web site. 8 August 2001. 〈http://www.nlm.nih.gov/medlineplus/ency/article/003751.htm〉.

"Urine Sample." General Health Encyclopedia. Health Central Website. 8 August 2001. 〈http://www.healthcentral.com/mhc/top/003751.cfm〉.