Nursing Study Guide/Care of Uro-Renal Needs
Using a bedpan or urinal
applying a penile sheath urine receptacle
Read the manufacturers directions before applying. Wear gloves. place adhesive and sheath according to instructions (devices differ and some require the adhesive be placed outside the sheath). Wash hands.
Urinary tract infection is the second most common type of human sepsis after respiratory conditions. Therefore, the general principle is to obtain a specimen not contaminated by skin or bowel flora. Various methods can be used, such as catheter or mid-stream urine collection. Cleanliness may be less critical in collection over longer periods, such as 24 hour collection for protein urea and creatinine assay, in which case general hygiene should be observed.
Client health education - how to obtain a midstream specimen.
- Wash hands before sitting on toilet.
- Part labia with one hand and irrigate genital area with normal saline or sterile towellette.
- Start urinating and catch a few drops from the middle of the stream.
- Recap specimen jar and wash hands.
- Ensure label and laboratory request paperwork complete before despatch.
- Document collection (e.g. to save the cost of unplanned repetition).
In difficult nursing situations, attempt the following alternatives Catheter specimen - Once the connection between a catheter and collection bag has been broken, the urinary system is exposed to environmental microbes. Care should be taken to keep the procedure as clean as possible. Some collection bags have luer lock connectors for use as aspiration ports. Some nurses even collect specimens using a needle and syringe taking care to avoid puncturing the balloon inflation tube. Paediatric collection may be attempted with a self-adhesive collection pouch after swabbing the skin to avoid contamination. Neonatal collection may be attempted by placing a specimen collection jar in the open nappy. Stimulate the baby's bladder stretch-receptors by very gentle rhythmic patting with finger pad over the supra-pubic area. This technique requires patience and the clients parents may be better motivated to achieve a result. Urgent collection may require bladder tap by a doctor using a needle.
Do not use drinking cups to collect urine specimens as they may be mistaken for consumables. Disposable cups marked as biohazard specimens should be used, ideally yellow to indicate a body fluid. Commercial all-in-one dip-stick tests are available, saving time over the use of hydrometer or separate chemical tests. Ensure the test strips are stored correctly and within the use-by date to guarantee accuracy. Specific Gravity varies from 1.000 (as dilute as water) to 1.310 (concentrated, indicating dehydration or pyuria).