How to Collect a 24-hour Urine Sample (Nursing)​

00:01 Hi! Welcome to our series on interpreting lab values.

00:05 I want to walk you through how to collect a 24-hour urine sample.

00:09 I know it's not that glamorous but it's really important because if you've ever had to call in the nephrologist and tell them you messed up a 24-hour urine sample.

00:18 You will thank me that this video will help you avoid ever having to do that.

00:24 So let's go back and talk about what a 24-hour urine collection is this means we're going to collect all the urine a patient excretes in a precise 24-hour period.

00:36 So that is so important. I want you to underline it.

00:38 No, I'm serious underline precise because it's got to be exactly 24 hours.

00:46 So the patient you pick a start time.

00:48 Usually it's a time in the morning.

00:49 Sometimes we pick eight in the morning.

00:51 It really doesn't matter but the start time has to be documented.

00:56 So if we're going to start at 8:00 in the morning, I would go use the restroom, empty my bladder at 8 a.m.

01:03 Now I discard that sample.

01:04 I don't keep it because I want to know just what goes on in a 24-hour period.

01:09 Now from after discarding that first sample at 8 a.m.

01:13 Everything else after that.

01:15 I'm going to have to keep that in the collection bottle.

01:18 Okay so when we get to 24 hours, I go to the bathroom one more time whether I feel like I needed or not and put it in the collection bottle and I take it to the lab for analysis.

01:29 If we're in the hospital, we send it down to lab that's in the same building if I'm doing this at home, which is really not that fun.

01:36 But if I'm doing this at home that I'm going to have to take the sample to the lab myself.

01:41 Okay, so why do we do these? Well, 24 hour urine tests are used to evaluate kidney function.

01:47 They can also help us diagnose kidney problems.

01:50 So there's lots of different things that we can use a 24 hour urine test to measure, so keep that in mind.

01:57 It could look protein, hormones, minerals all kinds of different things.

02:03 But if it's a 24-hour urine test, you want to be sure as the nurse you follow directions precisely.

02:10 So let's walk through that one more time again, because what is so hard about a 24 hour urine test? Well, maybe sitting where you are doesn't seem like that big a deal but it gets pretty complicated in a hospital setting with multiple people in and out and trying to help someone who might not feel great follow the directions explicitly, it's really important that you understand how a 24 hour urine test is so you can explain it to your patient because it's no good unless we get an accurate sample.

02:42 So see if you can walk through this with me again.

02:45 Let's start the test at 8 a.m.

02:47 What is your patient do? Right! they empty their bladder.

02:51 Do you save that sample? No! good.

02:55 All right, you're tracking with me.

02:56 So let's start at 8 a.m.

02:58 patient empties their bladder, we save that sample, now from 8:00 a.m.

03:03 after that discarded sample for the next 24 hours.

03:07 We're going to keep all the urine at the in this container.

03:11 Now, it's important that you write down on the label and all these tests come with a label, the date, and the start time of the test.

03:20 So for the next 24 hours, woohoo, you have to keep that urine cold.

03:26 Some people actually put it in a refrigerator, which doesn't go over really well with a people that live in your house but you gotta do what you gotta do.

03:34 In the hospital, we usually put the container on some ice in a tub to help keep it cold but it's got to stay cold.

03:42 Room temperature urine is too big a risk for growing bacterial growth and we don't want any of that messing up the sample.

03:49 So we started at eight discarded that sample then after 8 a.m. following we put all the urine in the container for 24 hours that were keeping cold.

04:00 However, you work that out and then at exactly 8:00 a.m. for our example.

04:05 What do you do? Well, if you don't have to pee is it a big deal? Yeah, it's a big deal at exactly 8:00 a.m.

04:13 You're going to have the patient empty their bladder again, whether they feel like it or not.

04:18 So whatever they need to do stick their hand under running water, warm water.

04:23 Whatever it is you want to make sure they squeeze the rest of the urine and out of that bladder, add it to the container, date it, time it, label it, and transport it to the lab whether you're at home or in the hospital setting.

04:37 So what's hard about it? Is making sure every one of those steps are followed.

04:44 Make sure it's also clearly labeled with the patient's name.

04:47 They need to have the date, the time, the start, and the stop time before you send that down to lab.