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.
 Planning
1. Explain the urine collection procedure
to the patients
2. Provide a specimen container and
instructions on how to cleanse the
genitalia and collect the urine.
 Implementation
STEPS RATIONALE

1.Provide equipment 1.Preparation enhances

for cleaning efficiency and
genitalia before decreases possibility
patients urinates. of contamination.
2. Instruct patient to 2. Done to avoid any
keep labia majora fecal matter to flow w/
separated while the urine.
urinating
 Implementation
3. For midstream 3. The 1st flow of urine
urine, instruct washes
women to void little microorganisms &
urine in the toilet debris from the
then catch 30-50cc urinary tract.
of midstream urine Midstream catch
directly to the sterile ensure a sterile
bottle. specimen.
 Implementation
4. Clean the outside 4. Capping of the
of the container and container prevents
cover. inadvertent spilling
and possible
contamination of
the specimen.
5. This eliminates the
5. Label the specimen error on the client.
properly
6. To avoid alteration
6. Perform the test of the results
promptly
 Implementation
7. Clean all the 7. This is a standard
equipment precaution. It
decreases
transmission of
microrganisms.
8. Documentation
8. Record time & type serves as legal
of examination 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

 IMPLEMENTATION
STEPS RATIONALE
 Fill the test tube  A fresh concentrated

2/3 of clear urine voided urine specimen

should be used.
 Done to avoid precipitate.
 Heat the upper
third of the test Too much heating of lower
tube. Lower test tube may results to
portion is not explosion
heated to serve
as control
 Implementation
STEPS RATIONALE
 If clouds forms, add  Cloudy urine is often
few drops of 5% due to phosphate
acetic acid. Heat precipitation in alkaline
again and allow urine. The phosphate
cooling. Read after 5 and Carbonates are
minutes 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 TEST
NORMAL 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
 Implementation
STEPS RATIONALE
1. Place 5 cc of 1. If its color changes
Benedict’s the solution is
solution in a clear contaminated
test tube. Heat, if
color changes,
discard.
Cont..
2. Add 8-10 drops of 2. The sugars that
urine and mix may occur in the
thoroughly urine can be
distinguised as the
basis of the test.
3. Boil for several 3. This is done to
minutes (2 mins) ensure adequate
results
 Interpretations
 Blue (-) = no  Sensitivity of the
sugar present test is
approximately 50-
80 mg of
glucose/100 ml.
 Green (+)= slight  It is usually = to
trace less than
50mg/100ml of
reducing sugar.
 Interpretation
 Yellow (++)= trace  Equivalent to 115-
550mg/100ml of
reducing sugar.
 Equivalent to 1400-
 Orange (+++)=
2000mg/100ml of
moderate amount
reducing sugar
 More than 2000-/
 RED (+++)= large 1000ml of reducing
amount sugar.
 The End

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