Urine Collection Urine Jug Protocol for 24-Hour Urine ...

[Pages:2]Urine Collection

Urine Jug Protocol for 24-Hour Urine Collections and Timed Collections

Look on the urine list for proper jug; after you have determined the correct jug, see the appropriate section for jug. See the Collection Manual for tests not on the list below. For inpatients, the laboratory staff will review ordered tests and evaluate the preservative needed. The jugs that contain a preservative may be labeled with a warning. After assigning the jug, write the patient's name (first and last), patient's identification number, test name, and jug preservative on the jug. Outpatients or the nursing unit should indicate the start time.

Acceptable Preservatives for Urine Collections (Analytes that share common preservatives can be assayed using the same specimen)

P=Preferred Y=Acceptable N=Not Acceptable

Analyte

Boric 6N HCl Acid

Acetic Acid

None

Protect

Jug

from Light

Aldosterone

N

Y

P

N

Amino Acid, Quantitative

N

N

N P (freeze)

Aminolevulinic Acid

Y

N

P

N

Amylase

Y

Arsenic

Y

N

Y

P

X - acid washed obtain

from laboratory

Beta-2-Microglobulin

Y

Calcium

Y

P

Cortisol Free

N

P

Y

N*

X - acid washed obtain

from laboratory

Chloride

Y

P

Cystine

Y

Creatinine Clearance

Y

Catecholamines Fractionation

Y

Y

P

N

Heavy Metals

Y

N

Y

P

X - acid washed obtain

from the laboratory

Histamine

Y

N

N

P

Yes

Iron

Y

N

Y

Y

Lead

Y

Y

Y

P

X - acid washed obtain

from laboratory

Magnesium

Y

Y

Y

P

Mercury

Y

N

Y

P

X - acid washed obtain

from laboratory

Metanephrines Fractionation

Y

Y

P

N

Myoglobin

Y

Organic Acids

Y

Oxalates

Y

Y

Y

N*

Porphobilinogen (Random Only) N

N

N

P

Yes

Porphyrins Fractionation

N

N

N

N

B - sodium carbonate

Yes

Uric Acid

Y

Vanillylmandelic Acid (VMA)

Y

Y

P

N*

Zinc

Y

N

Y

P

X - acid washed obtain

from laboratory

*Can add acid within 4 hours of collection. X - Jugs with no metal cap or glued insert in cap are acceptable.

Department Referral Referral Referral Chemistry Referral

Referral Chemistry Referral

Chemistry Referral Chemistry Referral Referral

Referral Referral Referral

Chemistry Referral

Referrals Chemistry Referrals Referrals Referrals Referrals Chemistry Referrals Referrals

Check individual test for specimen container and additive requirements. REFRIGERATE all urines if they are stored before delivery to the laboratory.

Clean-Catch Urine - Female Patients 1. Separate skin folds around urinary opening. 2. Wash urinary opening and its surroundings from front to back with a sterile antiseptic pad. 3. Rinse with clean water on gauze to avoid contamination from soap. 4. Begin urinating into toilet, making sure to keep skin folds apart with fingers on 1 hand. 5. Wait until urine stream is well established before moving container into path of the stream to catch rest of urine. 6. Do not touch cup to genital area. 7. Replace lid and label specimen. 8. Refrigerate specimen immediately.

Clean-Catch Urine - Male Patients 1. Wash end of penis well with a sterile antiseptic pad. 2. Rinse to avoid contamination with soap. 3. Begin urinating into toilet. Wait until urine stream is well established before moving container into path of the stream to catch rest of urine. 4. Do not touch cup to genital area. 5. Replace lid and label specimen. 6. Refrigerate specimen immediately.

24-Hour Urine Collection WARNING - Many 24-hour urine collections require an acid solution to preserve specimen. Patients should be cautioned NOT to urinate directly into container due to possibility of acid burns. Containers are provided by the laboratory. At the time the container is picked up, the appropriate preservative will be placed in the container, if applicable.

1. Record time collection is begun. 2. Have patient empty bladder at beginning of collection period and DISCARD urine. 3. SAVE all urine for next 24 hours. 4. At end of 24-hour period, empty bladder and SAVE urine. 5. Record time at end of collection. 6. If an aliquot of urine is requested, mix urine well, measure and record total volume and send requested volume of urine. 7. Refrigerate all 24-hour urine specimens during collection, and if storage is required prior to transport to laboratory.

General

? Early-morning urine specimens are preferred for routine urinalysis, but if this is not possible in cases of STATS and pre-Ops, send specimen to laboratory when requested by physician. SPECIMENS SHOULD NOT BE HELD ON NURSING UNIT ANY LONGER THAN 30 MINUTES.

? Bladder lavage is completely unsatisfactory if obtaining a catheterized urine specimen. ? For collection of catheterized urine specimens, use only sterile urine containers which will be found on catheter tray and may

also be secured from Supply Processing and Distribution. ? Collect infant urine specimens in pedi-bags or plastic urine containers. Specimens wrung out of cotton balls, diapers, sheets,

etc., are unacceptable. ? Urine specimens for bile and urobilinogen should be taken to laboratory IMMEDIATELY AFTER COLLECTION. Be sure

to let someone in laboratory know what specimens are for, so that they will be given immediate attention. ? Any specimen intended for culture must be collected under strictly sterile conditions and brought to laboratory immediately.

Stool specimens are an exception and should be brought in regular stool containers. ? An out patient that needs a catheterized urine will be sent to Emergency Services triage. Patient will be admitted and an

Emergency Services RN will collect appropriate specimen.

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