Collecting urine

Two types of urine specimens collected

First 20mL of urine stream. Can be collected any time of day but best collected first thing in the morning or at least 4 hours after last urination
NAAT to test for gonorrhoea, chlamydia, and trichomonas

Urine collected after allowing first part of urine stream to pass into the toilet. Usually need about 20mL
Albumin creatinine ratio (ACR) — protein secreted into urine from kidneys
Microscopy, culture and sensitivity (MC&S) — shows bacteria in urine

If collecting urine for drug screening — follow same procedure as MC&S —doesn't have to be mid-stream

Store urine dipsticks at less than 30°C and low humidity. May need to be in air-conditioned room
If it takes 12 hours or more for urine sample to reach pathology — also use dip slide for MC&S
Do ACR when person well. Best in morning after fasting — less false positive results from protein meals, exercise, infection
For MC&S you need plain urine, may also need dip slide, stained sample
Won’t need all these tests every time — check which ones you need
Give person paper bag to carry urine containers through public areas in clinic

Figure 5.27

Ask person to

Wash genital area with gauze swabs or sterile saline wipes, rinse with sterile water, dry with clean paper towel
Catch first lot of urine in jar 1 (about 20mL)
Catch second lot of urine in jar 2 (about 20mL)

For NAAT to test for gonorrhoea, chlamydia, trichomonas (jar 1)

For MC&S (jar 2)

Plain sample — at least 8mL of urine in jar 2
Dip slide (if needed) is POC Test agar plate, its purpose is avoiding misleading impressions produced by growth of organisms in urine sample between collection and arrival at laboratory

Stained sample (if needed) is a method to find cancer cells, renal (nephron/tubular) cells in the urine

Pipette 5mL urine from jar 2 into 5mL plain sterile container, add 3 drops of formalin, screw top on tightly
OR pipette urine into urine stain tube if available

Wash genital area well with soap and water using clean swabs or cotton wool balls

Rinse well with sterile water, dry well with clean gauze swab or paper towel
First practitioner holds baby up by underarms, legs dangling
Second practitioner uses 1 or 2 fingers to gently tap the suprapubic area at a rate of 100 taps per minute for 30 seconds — Figure 5.28

Figure 5.28

If baby doesn’t pass urine — gently rub lower back (lumbar area) in circular motion for 30 seconds — Figure 5.29
Alternative method is to gently rub the lower abdomen for a few minutes using a circular motion with a gauze soaked in cold water with specimen jar ready to catch urine
Repeat until mid-stream sample is caught — Figure 5.30. Usually within 5 minutes

Figure 5.29

Figure 5.30