Collecting the 24-hour fractional urine specimen
Authors: Брикез Ю. И.
Editor: Редненко В. В.
Description of the clinical situation:
You are a ward nurse of an inpatient health care organization. An urine specimen by Zimnitsky has been ordered for a patient. Prepare the patient and collect urine specimen by Zimnitsky.
Indications: determination of concentration and excretory function of the kidneys.
Equipments:
- urine collection containers with a volume at least 250 ml (8 main and 2 additional)
- container labeling stickers
- a referral for examination: бланк «Анализ мочи по Зимницкому»
Procedure for performing the practical skill:
Preparatory stage:
- say hello to the patient, introduce yoursel
- check the patient's name, check with a MAR (medication administration record)
- the day before (evening) inform the patient about the upcoming urine collection by Nechiporenko, obtain verbal consent for the collection.
- fill in the referral «Анализ мочи по Зимницкому»: indicate patient's surname, first name, year of birth, gender, department, ward number, date of urine collection
- Label urine collection containers: put the labels on the containers
- specify on each label:
- type of test (by Zymnitsky)
- patient name and initials
- department, ward number
- date of urine collection
- portion number
- the time of collection of urine corresponding to this portion
- teach urine collection techniques:
Main Stage:
- give the completed referral and labeled urine containers to the patient
- explain the urine collection rules to the patient:
- The sampling is carried out with the usual drinking and nutrition regime during the day (24 hours) in the form of eight portions
- at 6.00 a.m. the patient release urine into the toilet (night urine)
- perform the daily washing the external genitalia
- over the next 24 hours to collect urine in separate urine containers according to the time indicated on the container tag:
portion №1 6.00 - 9.00 portion № 5 18.00 - 21.00
№2 9.00 - 12.00 № 6 21.00 - 24.00
№3 12.00 - 15.00 № 7 24.00 - 3.00
№4 15.00 - 18.00 № 8 3.00 - 6.00
- warn the patient that a medical personnel will wake him up atnight to collect the appropriate amount of urine
- If the amount of urine excreted in a three-hour period is more than the volume of the urine collection container, use an extra container labeled “Extra Urine for Portion No.”
- when there is no urine in any time (three-hour) interval, the appropriate urine collection container is left empty and the tag is labeled “No portion”, this container is transported to the lab together with other
- The ward nurse will provide delivery of specimens to the lab before 8 a.m.
- Normal relative density of urine in an adult is 1.010 to 1.025 g/L.
Final stage:
- the ward nurse ensures delivery of the samples to the laboratory of the health care organization before 8 a.m. in a container for transportation of biological material samples, enclosing the referral forms in a separate bag
- the ward nurse staples the results of the laboratory tests to the medical card of an inpatient.
Note:
- If the patient is on a bed regime, the ward nurse should collect the urine specimens
- If the patient on period on the day of the examination, close the vagina with a tampon when urinating.
- The amount and relative density of urine in each portion is determined.