BACHELOR OF SCIENCE IN NURSING:

MICROBIOLOGY & PARASITOLOGY IN NURSING

LABORATORY MODULE LABORATORY UNIT WEEK
11 3 14
Urine Specimen Collection for Different Evaluations

✓ Read course and laboratory unit objectives

✓ Read study guide prior to synchronous class attendance
✓ Read required learning resources; refer to course unit terminologies for jargons
✓ Participate in weekly discussion board (Canvas)
✓ Submit course unit tasks

At the end of this unit, the students are expected to:

1. Understand the importance of correct urine collection in disease detection and medical regiment
2. Demonstrate accurately the skills in collecting urine specimen for different evaluations/test
3. Enumerate how to properly dispose soiled items used in urine collection

https://www.cdc.gov/urdo/downloads/SpecCollectionGuidelines.pdf
https://www.hamad.qa/EN/Hospitals-and-services/Hamad-General-Hospital/Hospital-Services/Clinical-
Departments/Documents/Urine Collection Procedure Manual 202018-2020 guide.pdf
Urine Specimen Collection (UA)

Urine specimen has long been a routine test or source for measuring health and well-being and remains an
important tool for clinical diagnosis. Abnormalities in urine may be a sign of certain disease or condition if certain
amounts of proteins or other substances are not within a normal range.

The clinical information obtained from a urine specimen is influenced by the collection method, timing and
handling. This is why proper collection of urine specimen is important to avoid contamination of the specimen or
deterioration of urine constituents.

OVERVIEW OF URINE COLLECTION:

Urine is made up of water and dissolved chemicals, such as sodium and potassium; also contains urea
made when protein breaks down; creatinine, which is formed from muscle breakdown; and certain amounts of these
waste products.

General Characteristics &

Chemical Determinants Microscopic Exam of Sediment
Measurements
Color: pale yellow to dark amber is Glucose: negative Casts: negative (occasional hyaline
mainly determined by the Ketones: negative casts)
concentration of the pigments Blood: negative Red blood cells (RBCs): negative
urochrome, urobilin and uroerythrin Protein: negative or rare
Clarity: clear to cloudy due to Nitrate for bacteria: negative White blood cells (WBCs):
leukocytes, bacteria, epithelials or Leukocyte esterase: negative negative or rare
precipitation of phosphates Crystals: negative
Specific gravity (sp gr):may range Epithelial cells: few
between 1.001 and 1.025
pH: 4.5 - 8 (average pH around 6)
Volume: 1000-2500cc/24 hours
(adult)

GENERAL CONSIDERATIONS:
1 Proper collection of urine specimens is important to avoid contamination of the specimen or deterioration
of urine constituents.
2 Ensure the urine collection container is clean and the container manufacturer has guaranteed that
interfering substances will not leach into the specimen.
3 If the specimen is a voided specimen, it is important to provide patients with instructions for proper
collection.
 4 The first voided morning specimen is particularly valuable because it is more concentrated and
abnormalities are easier to detect.
5 An early morning specimen is also relatively free of dietary influences and changes due to physical
activity.
6 Single random specimens may be taken at any time of the day or night.
7 The laboratory needs at least 10 ml of urine for a routine UA.
8 The perineal area in women or the end of the penis in men should be cleaned before the urine is
collected.
For a female, collecting midstream urine lessens the contamination from vaginal secretions or menstrual
flow.
Wiping the genitalia with a sterile wipe may stimulate the voiding reflex in infants.

9 If a culture and sensitivity are to be completed in addition to the routine UA, the urine specimen must be
placed in a sterile container.
10 Urine specimens need to be examined within 2 hours. Urine that is left to standing too long becomes
alkaline because bacteria begins to split the urea contained in urine into ammonia
11 A urine specimen should be refrigerated if it cannot be sent to the laboratory within 2 hours

SKILL: MIDSTREAM URINE SPECIMEN COLLECTION

1. Review doctor’s order for 3. Label the outer sides of 4. Ask the patient to wash their
urine specimen collection. the container with the hands with soap and water and dry
2. Greet and obtain patient’s name, date and them, to reduce the risk of the
informed consent and time specimen being contaminated
explain the procedure to
optimize the quality of the
specimen.
FOR FEMALE CLIENT:

5. Instruct client to: 6. Instruct client to: 2. Instruct client to:

a. Spread your labia (the a. Keeping your labia a. Without stopping your urine
folds of skin around your spread, stand over the stream and while spreading your
urinary opening and toilet or commode. labia, urinate into the urine cup
vagina) with the thumb and b. Start urinating into the toilet until it’s half full
forefinger of your non- or commode b. Finish urinating in the toilet
dominant hand (the hand c. Don’t collect the first part of your or commode
you don’t write with) urine stream
b. Wipe from front to back. Use
1 wipe for the left side, 1
wipe for the right side, and 1
wipe for the center (over
your urinary opening).
c. Throw the wipes away in the
trash

FOR MALE CLIENT:

5. Ask male patient to clean 6. Ask patient to pass 15 to 30 ml of 7. Ask patient to collect the middle
around the urethra meatus urine into the toilet to wash away part of the stream in the
to reduce the risk of any bacteria colonizing the distal specimen container and void the
contamination urethra remaining urine in the toilet
- Uncircumcised men should
retract the foreskin
 8. Tell patient to tightly screw 9. Instruct patient to wash hands 10. With gloved hands, receive and
the lid onto the urine check the specimen from the
cup. Don’t touch the inside patient
of the lid or cup or the
yellow sticker.

11. Complete the 12. Bring the specimen to 13. If in case lab tech is 14. Wash hands.
specimen request the laboratory. unavailable, place the
form and send to urine specimen inside
laboratory the body of the
refrigerator max of 2 hrs.

https://www.cdc.gov/urdo/downloads/SpecCollectionGuidelines.pdf
https://www.hamad.qa/EN/Hospitals-and-services/Hamad-General-Hospital/Hospital-Services/Clinical-
Departments/Documents/Urine Collection Procedure Manual 202018-2020 guide.pdf
 MICROBIOLOGY and PARASITOLOGY LABORATORY
Lab Report # 11 ( URINE COLLECTION)

NAME: Arianne Jans E. Munar Date: 05-10-21

Year and Section: BSN 1Y-6

I. Case discussions
1. A doctor requested a urinalysis on a 5 year old girl. Give your instructions to the mother on the proper
collection of urine in this patient. You can use “Filipino or Tagalog “ to instruct your patient.
-Mother will be provided with container for the collection of urine specimen. 
-Mother has to clean her hands with soap & wipe it before doing this procedure. 
-Clean the skin around urinogenital area.
2. A doctor requested a urinalysis on a 35 year old female. Give your instructions to the mother on the
proper collection of urine in this patient. You can use “Filipino or Tagalog “ to instruct your patient.
-Mother will be provided with container for the collection of urine specimen. 
-Mother has to clean her hands with soap & wipe it before doing this procedure. 
-Clean the skin around urinogenital area.
3. How will you collect urine for analysis in a patient with urinary catheter? Explain.
-Insert the needle gently into Foley catheter (if the catheter is a self-sealing type) at a 45 degree angle, or if Luer-lock
connection, twist on a sterile syringe to the port and slowly withdraw 20-30 mL of urine. 7. Remove needle from Foley
catheter and push urine into sterile specimen container. Cover container.

II. What is the result of urinalysis if there is urinary tract infection? Explain.
-An increased number of WBCs seen in the urine under a microscope and/or positive test for leukocyte esterase may
indicate an infection or inflammation somewhere in the urinary tract. If also seen with bacteria (see below), they
indicate a likely urinary tract infection.
III. Why is it important to get a sample for a urinalysis before initiation of antibiotics? Explain.
-This test checks for bacteria in your urine that could be causing an infection in your urinary tract. The urinary tract
includes ... Start urinating directly into the toilet, then urinate into the sterile container to collect a sample. Fill the
container as ... affect my test results? Taking antibiotics right before the test may affect your results
IV. What is the gold standard for the diagnosis of UTI? Explain.
-The gold standard for the diagnosis of a urinary tract infection is the detection of the pathogen in the presence of
clinical symptoms. The pathogen is detected and identified by urine culture (using midstream urine). This also
allows an estimate of the level of the bacteriuria.
V.What are some factors which can affect the results of urinalysis?
-Drug test results are influenced by several factors, including the amount and frequency of drug use.
Additional factors include drug test sensitivity and the amount of time between use and sample collection.
VI. Before urin analysis, what are some nursing interventions and instructions that can be given to a patient?

-Before your test, make sure to drink plenty of water so you can give an adequate urine sample. However, drinking excessive
amounts of water may cause inaccurate results.
One or two extra glasses of fluid, which can include juice or milk if your diet allows, is all you need the day of the test. You
don’t have to fast or change your diet for the test.

Also, tell your doctor about any medications or supplements you’re taking. Some of these that can affect the results of your
urinalysis include:

 vitamin C supplements
 metronidazole
 riboflavin
 anthraquinone laxatives
 methocarbamol
 nitrofurantoin

Some other drugs can affect your results as well. Tell your doctor about any substances you use before doing a urinalysis.

VI. What are some nursing interventions and instructions that should be given to the patient after urine collection?
- Nurses are responsible for specimen collection, preparation of the patient and handling. ... Know the importance of
various specimen collection for patient care and ... Bedpan should be provided when the patient is ready. ... Test kit
(with detailed instructions); Test cards; Brush or wooden applicator; Gloves.
VII. Aside from UTI, what are other diseases which can be diagnosed through urine analysis?
Explain the results of urine analysis for each of these diseases?
- A urinalysis is a test of your urine. A urinalysis is used to detect and manage a wide range of disorders,
such as urinary tract infections, kidney disease and diabetes. A urinalysis involves checking the
appearance, concentration and content of urine.