Urine Collection

NCM 101

Urine Collection Urine specimen by midstream catch is

a method of obtaining a urine sample to be sent for various test including routine urinalysis and urine culture. Or other tests that require uncontaminated urine for accurate results.

Purpose Urine specimen by midstream catch is

used to determine bacteremia, in addition to protein, glucose and ketones in pregnant women.

Planning1. Explain the urine collection procedure

to the patients2. Provide a specimen container and

instructions on how to cleanse the genitalia and collect the urine.

ImplementationSTEPS

1.Provide equipment for cleaning genitalia before patients urinates.

2. Instruct patient to keep labia majora separated while urinating

RATIONALE

1. Preparation enhances efficiency and decreases possibility of contamination.

2. Done to avoid any fecal matter to flow w/ the urine.

Implementation3. For midstream

urine, instruct women to void little urine in the toilet then catch 30-50cc of midstream urine directly to the sterile bottle.

3. The 1st flow of urine washes microorganisms & debris from the urinary tract. Midstream catch ensure a sterile specimen.

Implementation4. Clean the outside

of the container and cover.

5. Label the specimen properly

6. Perform the test promptly

4. Capping of the container prevents inadvertent spilling and possible contamination of the specimen.

5. This eliminates the error on the client.

6. To avoid alteration of the results

Implementation7. Clean all the

equipment

8. Record time & type of examination

7. This is a standard precaution. It decreases transmission of microrganisms.

8. Documentation serves as legal record & for the continuuity of care

HEAT + ACETIC ACID TEST

NCM 101

DEFINITION:

It is a test for presence of albumin in urine. TOXEMIA is a disorder during 3rd trimester characterized by increase in blood pressure and presence of edema

It is a test used to detect presence of protein in urine.

PURPOSE: To detect presence of prtein in the

urine To help evaluate and monitor

kidney function To help detect and diagnose early

kidney damage and disease

IMPLEMENTATIONSTEPS

Fill the test tube 2/3 of clear urine

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

RATIONALE A fresh concentrated

voided urine specimen should be used.

Done to avoid precipitate. Too much heating of lower test tube may results to explosion

ImplementationSTEPS

If clouds forms, add few drops of 5% acetic acid. Heat again and allow cooling. Read after 5 minutes

RATIONALE Cloudy urine is often

due to phosphate precipitation in alkaline urine. The phosphate and Carbonates are redissolved when acetic acid is added and provided optimum Ph.

PRINCIPLE: protein coagulates when heated.

INTERPRETATIONS: If CLOUDINESS persist after 5 min, it

is due to the presence of albumin. If CLOUDINESS disappear, it is due

to the presence of PHOSPHATE.

PREGNANCY INDUCED HYPERTENSION (PIH)

originally called TOXEMIA

PATHOPHYSIOLOGIC BASIS:

Vascular spasm

Hypertension edema proteinuria

Nursing Consideration Follow strict standard precaution in

obtaining specimen Collect specimen from the site with the

most viable and active microorganism Collect specimens in sterile containers

to avoid contamination

BENEDICT’S TEST It is a test for presence of sugar in

urine. It is done in pregnant mothers to determine diabetes.

Is a reagent used as a test for the presence of reducing sugar such as glucose, lactose and fructose, but not sucrose in a solution.

Gestational Diabetes

24th to 28th week to all gravidas women who do not begin pregnancy

with diabetes become diabetic during pregnancy (approximately 2-3%)

RISK FACTOR– Obesity– Family history of diabetes– Family History of Gestational Diabetes– Hypertension, Pregnancy Induced

Hypertension– Recurrent UTI’s, monilial vaginitis– Polyhydramnios– Proteinuria, Glycosuria

3 HOUR GLUCOSE TOLERANCE TESTNORMAL FINDINGS:

FBS - 80-100 mg/dl 1 hr< 190mg/dl 2 hrs<165mg/dl 3 hrs<145mg/dl

GLUCOSE SCREENING TEST

FINDINGS:– If FBS is more than 90mg/dl and at

1 hr post glucose loading is more than 140mg/dl, DIABETIC.

EFFECTS OF DIABETES IN PREGNANCY

 increase risk of maternal infections pregnancy induced hypertension hydramnios (.2,000ml amniotic fluid) preterm labor macrosomia (large for gestational age

but may have immature organ systems)

Severe Cases congenital anomalies prematurity respiratory distress syndrome untreated ketoacidosis coma and death (mother and fetus)

Purpose of Benedect’s Test

It can be used to test the presence of glucose in urine; glucose found to be present in urine is an indication of diabetes

ImplementationSTEPS

1. Place 5 cc of Benedict’s solution in a clear test tube. Heat, if color changes, discard.

RATIONALE1. If its color changes the solution is

contaminated

Cont..2. Add 8-10 drops of

urine and mix thoroughly

3. Boil for several minutes (2 mins)

2. The sugars that may occur in the urine can be distinguised as the basis of the test.

3. This is done to ensure adequate results

Interpretations Blue (-) = no

sugar present

Green (+)= slight trace

Sensitivity of the test is approximately 50-80 mg of glucose/100 ml.

It is usually = to less than 50mg/100ml of reducing sugar.

Interpretation Yellow (++)= trace

Orange (+++)= moderate amount

RED (+++)= large amount

Equivalent to 115-550mg/100ml of reducing sugar.

Equivalent to 1400- 2000mg/100ml of reducing sugar

More than 2000-/ 1000ml of reducing sugar.

The End

Thank You,Have a good

Day!