Urine Specimen Collection

What are the three urine specimen types?

Random, First morning, and Timed

When is a random urine specimen taken?

Urine can be collected at any time

When is a First morning specimen taken?

In the morning, the first urine that is voided after sleeping

When is a timed urine collection taken?

Collected in a large container over a specific timed interval.

What types of cells are more concentrated during first morning specimens?

Casts, white blood cells, red blood cells, epithelial cells, nitrites and proteins. However, after sitting for awhile, crystal formations can also become an issue and mess with testing.

Random tests are more often used for?

Routine screening

What type of tests require a timed collection?

Tests for hormone function and GFR

What are the two ways timed collection specimens can be taken?

Either by collecting urine during a specific time of day, or collecting urine over 12 hours or 24 hours.

What is the preparation and use of a routine void specimen?

No prep needed; routine screening

What is the prep and use of a midtsream clean catch specimen?

Prep: The genital area is cleaned before collection. The patient passes initial urine into the toilet, stops, and collects urine into a container, and then stops and empties the rest of the bladder into the toilet.

Use: Bacterial/Fungal cultures; Routine screening; Cytology

What is the prep and use of a catheterized urethral specimen?

Prep: catheter is placed into bladder via urethra

Use: Bacterial/Fungal cultures and routine screening

What is the prep and use of a catheterized ureteral specimen?

Prep: Catheter inserted into ureters via urethra and bladder, urine is collected before it gets to the bladder

Use: Determine kidney function/determine what part of kidney is damaged

What is the prep and use of a Suprapubic aspiration specimen?

Prep: Use a sterile needle to penetrate the bladder above the pubic region

Use: Bacterial and fungal cultures (anaerobic microbes)

What is the prep and use of a Pediatric collection bag?

Prep: Bag is adhered onto skin after cleaned and dried, used with patients unable to urinate voluntarily (pre-potty trained)

Use: Routine screening and quantitative assays

What are all of the potential reasons to reject a urine sample?

Mislabeled specimen; Inappropriate collection/specimen type; improper preservation; visibly contaminated; insufficient volume

What is the ideal urine volume needed for testing?

Routine: 10mL - 15mL

24-hour: Only small amount needed for testing, but 20mL - 50mL is kept for repeat tests

Which of the following is the urine specimen of choice for cytology studies?

Random Specimen

Which of the following specimens usually eliminates contamination of the urine with entities from the external genitalia and the distal urethra?

Midstream clean catch specimen

Substances that show diurnal variation in their urinary excretion pattern are best evaluated using a

Timed collection

Which of the following will not cause erroneous results in a 24-hour timed urine collection?

The collection starts and ends in the evening

A 25-year-old woman complains of painful urination and is suspected of having a urinary tract infection. Which of the following specimens should be collected for a routine urinalysis and urine culture?

Midstream clean catch

Which of the following tests requires a timed urine collection?

Creatinine clearance test

An unpreserved urine specimen collected at midnight is kept at room temperature until the morning hospital shift. Which of the following changes will most likely occur?

Decrease in glucose and ketones

A urine specimen containing the substance indicated is kept unpreserved at room temperature for 4 hours. Identify the probable change to that substance.

Bacteria: Increase

Bilirubin: Decrease

Glucose: Decrease

Ketones: Decrease

pH: Increase

Protein: No Change

Urobilinogen: Decrease

Which of the following is the most common method used to preserve urine specimens?

Refrigeration

If refrigeration is used to preserve a urine specimen, which of the following may occur?

Amorphous crystals may precipitate

Which of the following urine preservatives is acceptable for both urinalysis and urine culture?

Boric acid

How much urine is usually required for a ‘manually’ performed routine urinalysis?

10 to 15 mL

Which of the following substances is higher in urine than in any other body fluid?

Creatinine