URINE

 liquid or water waste product

 expelled from your body through your urethra
Composition of urine:
 water
 urea, uric acid, ammonia, hormones, dead blood cells,
proteins, salts and minerals, and toxins.
How urine was made?
 Urine is created by your kidneys.

 How does the urine pass through the body?

CHARACTERISTIC NORMAL ABNORMAL
Amount in 24 hours (adult) 1200-1500 mL Under 1200 mL
*a large amount over intake
Color, clarity Straw, amber, transparent Dark amber, cloudy, dark
orange, red or brown, mucous
plugs
Odor Faint aromatic Offensive
pH 4.5-8 Over 8
Under 4.5
Specific gravity 1.010 to 1.025 under 1.010
over 1.025
Glucose Not present present
Ketone bodies (acetones) Not present Present
Blood Not present Present
Bacteria and pus cells Not present present
 CLEAN CATCH/MIDSTREAM URINE

 A clean catch urine sample or specimen is one of the least

invasive procedures for a urine culture or urinalysis.
 The clean catch method aims to prevent bacteria from the
skin of the penis or vagina from contaminating the urine
specimen.
 CLEAN CATCH/MIDSTREAM URINE
 A single sample of urine is normally used to determine
whether there are increased amounts of specific
substances in your urine.
 The urinalysis is a "snapshot" assessment of your urine at
one point in time.
THINGS TO NOTE:
Urine specimen bag for infant
 SUBMIT SPECIMEN IMMEDIATELY TO THE LABORATORY.
 INDICATE NAME AND OTHER SECONDARY INDICATOR
 MENSTRUATION
 PROCEDURES WITH DYE

 SEE CHECKLIST
24-HOUR URINE SPECIMEN COLLECTION

 Your urine collection is for 24 hours.

 Primary test for urine clearance.
 Patients do not need to follow any special
instructions about urine collection. You may follow
your usual routine.
 Why 24 Hour Urine Collection is needed?

Doctors need to know:

 how much urine your body is producing in a day
 or how much of a particular substance is eliminated in a day.
*A single-specimen urinalysis cannot provide this information, so
patients are instructed to collect all their urine produced in a 24-hour
period.
 A special container is provided for this purpose, which is returned to the
laboratory after you have finished the urine collection at home.
 Diet: Check doctor’s order.
Arsenic, Calcium, Copper, or Heavy metal screen:
Do not eat shellfish for 48 hours before you start your urine collection and
during the 24 hours you collect urine.
Calcium:
Do not take laxatives during the 24 hours you collect urine.
And do not take anything that contains L-dopa, acetaminophen or
salicylates, or cough syrup that contains guaifenesin.
Oxalate
Do not take more than 2 grams of vitamin C during the 24 hours you
collect urine.
THINGS TO NOTE:
 SUBMIT SPECIMEN IMMEDIATELY TO THE
LABORATORY.
 INDICATE NAME AND OTHER SECONDARY
INDICATOR
 MENSTRUATION
 PROCEDURES WITH DYE
 See checklist
 URINARY CATHETERIZATION

 Introduction of a catheter into the urinary bladder.

 This is usually performed only when absolutely necessary
because the danger exists of introducing microorganisms into
the bladder.
 ASEPTIC TECHNIQUE

KOZIER AND ERB'S FUNDAMENTALS OF NURSING

CLINICAL ALERT

 The insertion of urinary catheter is one of the most

common causes of hospital acquired infection (nosocomial
infection)

KOZIER AND ERB'S FUNDAMENTALS OF NURSING

INFECTION CONTROL MEASURES
 Anchor catheter with securement device/tape to minimize
in and out motion to urethra.
 Avoid catheter manipulation around meatal area-can
contribute to bacterial migration into bladder
 Prior to exercise/ambulation or transfer, drain all urine
from tubing into drainage bag to prevent retrograde flow
of urine into bladder
INFECTION CONTROL MEASURES
 Use aseptic technique with sterile equipment upon insertion
 Keep drainage bag below bladder (GAVITY DRAINAGE)
 Do not allow tubing to loop, dangle, fall below drainage bag, or kink
—keep patent.
 Wash hands before and after, wear gloves with each urinary catheter
bag emptying
 Do not place urinary drainage bag up between patient’s legs.
 Do not let bag lay on floor.
 

SAFETY
 Catheterization: ABORT procedure if resistance is met, bleeding is
noted, patient complains of severe pain
TROUBLESHOOTING-SELECTED SITUATIONS
 Leakage Management
 Bladder Distention
 Blockage/Lumen Occluded
 BLADDER SPASMS 
  REPORTABLE CONDITIONS
 Unable to insert/pass urinary catheter.
 Leaking around insertion site/new drainage from meatal area
 Low or no urine output
 Color change of urine-cloudy, red
 Obstruction/unable to irrigate
 S&S of UTI: Fever > 38C chills, flank pain, changes in urine character
and positive urine culture
 Appearance of Phimosis-tightened foreskin compromising blood flow to
glans penis
REMOVAL OF IFC
 Indwelling catheters are removed after purpose has been
achieved.
 If catheter has been placed for a short period of time (few
days), the client usually has little difficulty regaining normal
urinary elimination pattern.
 Clients who have retention catheter for a prolonged period may
require bladder training to regain bladder muscle tone.
 BLADDER TRAINING
BLADDER TRAINING requires the client postpone voiding
, resist or inhibit the sensation or urgency and void according
to the timetable rather than the urge too void.
 See checklist
Catheterized Urine Specimen Collection

Principles involved
Procedure
Purpose:

To obtain urine specimen for microbial analysis

 Keypoints:
 Sterile urine specimens can be obtained from a closed
drainage systems.
 Nurses need to be aware that any breaches in the closed
system such as:
 emptying of the urinary drainage bag
 taking a urine sample
increase the risk of catheter-related infection
The sampling technique used in catheter specimen of urine
collection is important.

Why?
An incorrect sampling technique could introduce infection
and cause inaccuracy in results, diagnosis and treatment.
 aseptic technique
 sampling port
 This port is usually situated in the drainage tubing, proximal to the
collection bag which ensures the freshest sample possible.
 The use of drainage systems without a sampling port should be avoided
 Needle-free systems - which may reduce the risk of inoculation injury.
 Aspiration of urine from the body of the catheters can be done
only with self sealing rubber catheters

 30 TO 45 DEGREE ANGLE
 Specimens should not be collected from the main collecting
chamber of the catheter bag as colonization and multiplication of
bacteria within the stagnant urine or around the drainage tap may
have occurred.
 The drainage system should not be disconnected because this
increases the risk of bacterial contamination
 It is said that:

 Bacteriuria (the presence of bacteria in urine) is

unavoidable with the use of indwelling urinary catheters and
a catheter inevitably becomes colonized with micro-
organisms
 However, bacteriuria alone does not always mean that the
patient has a urine infection requiring treatment with
antibiotics
 IMPORTANT!!

FOLLOW HOSPITAL’S PROTOCOL

KINDS OF IFC
WHERE TO CLAMP?
HOW LONG WILL YOU CLAMP?
Assess!

30minutes
 See checklist
TRAIN YOUR MIND TO SEE THE GOOD IN
EVERYTHING.

Eyes on the slides
1. What is the purpose of catheterized
urine specimen collection?
True or false

2. Aspiration of urine from the body of the

catheters can be done only with plastic
catheters
3 and 4.
How nurses can breach in the closed
system drainage of IFC that increase the
risk for catheter-related infection?
5. Angle of aspiration for catheter
collection of urine.
6. Bacteria in the urine is unavoidable
with the use of indwelling urinary
catheters and a catheter inevitably
becomes colonized with micro-organisms
What do you call the medical term for
presence of bacteria in the urine?
Pass or fail

7. Clamp catheter above the port and

aspirate specimen below the clamp
8. Name this catheter
True or false

9. The urine should be squirted into the

specimen pot via the needle to preserved
the casts or any cells present.
10.A urine specimen obtained through
catheterization is a:
a.Random urine specimen
b.Clean-catch mid stream urine specimen
c.First morning urine specimen
d.24-hour urine specimen