When collecting a 24-hour urine sample for a client, the nurse aide should request that the client

Collection and Preservation of 24-Hour Urine Specimens

Patient:
The 24-hour collection container may contain chemicals (as a preservative) that are hazardous. DO NOT urinate directly into the container. Collect urine in a clean, dry vessel and carefully pour the urine into the 24-hour collection container.

Follow your physician’s advice regarding any food, drink or drugs before and during collection.
Empty your bladder completely upon awakening and discard this urine. This is your start date and time. Write it on your paperwork and/or the collection container.
Collect all urine for the next 24 hours. The last urine collected should be that voided upon awakening the second day, at the same time as the start time.
Recap the collection container carefully and completely.
Return the collection container to where you were instructed to return it as soon as possible.

NOTE: Some urine tests require that the 24-hour urine collection be refrigerated during collection. Follow your physician’s instructions for all collection procedures.

Provider/Nurse:

If it is necessary to measure the total amount of soluble substances excreted in a 24-hour period, a strictly timed 24-hour specimen is required, because many soluble substances exhibit diurnal variations.

Collect the specimen in one or more disposable, wide-mouthed, clean plastic container(s) with a plastic lid large enough to hold about 3 L. Amber-colored containers may be required for light-sensitive analytes.
Determine if the collection will require a preservative, ensuring the collection container has the appropriate preservative, at the correct concentration, along with a warning label indicating the preservative in use.
Label the collection container including the patient identification (name and hospital number), test(s) required, and preservative used.
The start date and time plus the finish date and time should be recorded on the container and requisition at the beginning and end of the collection period.
The 24-hour collection should begin by having the patient empty his or her bladder or catheter bag at a fixed time and discard the specimen. Record this start date and time on the collection container and on the laboratory requisition.
If a preservative is required, the patient must be advised to collect the urine in a separate clean container and then carefully transfer the urine to the collection container that will be transported to the laboratory. Comment: Assume that all preservatives are hazardous (most are).
Instruct the patient (or nurse) to collect all voided urine during the 24-hour collection period and add it to the collection container.
The collection should end exactly 24 hours after it began, by having the patient empty his or her bladder, or catheter bag, and adding this specimen to the collection container.
Record the ending date and time on the collection container and on the laboratory requisition.
Carefully seal the cap tightly so as to avoid leakage.

Consult the following on-line resources:
Department of Nursing Services and Patient Care policies:
Pathology Laboratory Services Handbook:

While performing a 24-hour urine collection, a nursing assistant notes that the 24-hour container has a preservative added. The nursing assistant should understand that this means:a. the specimen has been contaminatedb. the specimen must be refrigeratedc. the specimen will not need to be refrigerated

d. the specimen can remain on the nursing unit for 48 hours before being transported to the laboratory

c. the specimen will not need to be refrigerated

A patient tells the nurse that he needed to urinate while away from home and was not able to collect the urine for 24-hour analysis. How should the nurse handle this situation?a. Tell the patient not to miss any more samples and to continue with the collection processb. Tell the patient that he will need to restart the collection processc. Tell the patient that testing may be inhibited and results less than accurate, but that the current collection will continue

d. Tell the patient that it will not affect the testing

b. Tell the patient that he will need to restart the collection process

A nurse is monitoring a 24-hour urine collection. Midway through the collection period, the nurse notices that the patient’s urine is straw-colored. What should the nurse know about the urine based on the color?a. The patient is jaundicedb. The urine is normal in appearancec. There is no urinary tract infection

d. There is no bleeding in the urinary tract

a. The urine is normal in appearance

The most common mistake in 24-hour urine collection isa. failing to refrigerate the specimenb. failing to add or adding an incorrect amount of preservativec. under-collection of urine

d. contamination of the specimen

c. under-collection of urine

The 24-hour urine specimen container is dark in color, whicha. prevents inactivation of preservativesb. protects the light-sensitive elements in the urine such as urobilinogen or porphyrinsc. prevents other patients or visitors from knowing that the patient is undergoing urine collectiond. helps to prevent bacterial contamination of the specimen

e. all of the above

b. protect the light-senstive elements in the urine such as urobilinogen or porphyrins

The student nurse is educating an ambulatory patient about collection of a 24-hour urine specimen. She explains that all urine excreted over 24 hours must be included in sample. She shows the patient the specimen container, instructs the patient to urinate directly into it with each void, and reminds the patient to close the lid tightly after use and keep it in the basin of ice water at the bedside. The nurse preceptor intervenes and corrects the student nurse at which point?a. When she states that all urine over 24 hours must be collectedb. When she instructs the patient to void directly into the specimen containerc. When she tells the patient to close the lid tightly after use

d. When she instructs the patient to keep the container on ice

b. When she instruct the patient to void directly into the specimen container

In a patient with obstructive jaundice, the urine specimen maya. have a yellow-brown or green-brown tintb. be cloudy with sedimentc. be rust-colored

d. have a red-brown appearance

a. have a yellow-brown or green-brown tint

The nurse has begun 24-hour urine collection on a patient with a urinary catheter. To facilitate correct completion of the procedure, the nurse shoulda. document the time that the 24-hour collection was begunb. place signs above the patient’s bed to alert personnel that a 24-hour urine collection is in processc. explain the procedure and its purpose to the patientd. answer questions and provide emotional support as needed

e. all of the above

Which of the following patients is most likely to undergo 24-hour urine collection to diagnose, monitor, and treat their medical condition?a. A 24-year-old male who is being evaluated for hyperthyroidismb. A 9-year-old female who is being assessed for a fractured wristc. A 52-year-old male who is being evaluated for renal diseased. A 62-year-old female who is being assessed for multiple sclerosis

e. All of the above

c. a 52 year old male who is being evaluated for renal disease

The Clinical and Laboratory Standards Institute (CLSI) recommends the use of chemical preservatives if the urine specimen cannot be processed within two days of collection.a. True

b. False

he nurse should label a urine specimen container with which of the following information?a. Date and time the collection was started and finishedb. Patient’s attitude about urine collectionc. Other laboratory tests orderedd. Patient’s full name and medical record numbere. Laboratory test resultf. a) and d)

g. b) and e)

f. a) Date and time the collection was started and finished and d) Patient's full name and medical record number

After completing a 24-hour urine collection, the nurse shoulda. arrange for prompt transport of the specimen in ice to the laboratoryb. review the patient’s test resultsc. freeze the urine for 24 hours prior to sending it to the laboratory for testing

d. arrange for heating of the urine in a beaker to 110°F (43.4°C)

a. arrange for prompt transport of the specimen in ice to the lab

The nurse who is preparing to perform a 24-hour urine collection for a patient should be aware that because a refrigerator is not available for storing the urine containera. the urine samples must be sent immediately for testing throughout the 24-hour periodb. a chemical preservative should be added to the specimen container at the end of the 24-hour periodc. the urine samples must be kept in a container filled with warm water

d. the urine specimen container should be placed on ice

d. the urine specimen container should be place on ice

The nurse is providing care for a patient who is undergoing 24-hour urine collection when he/she notices that the urine samples are foul-smelling. The nurse should recognize that this may indicatea. leukocytosisb. urinary tract infection (UTI)c. bleeding in the urinary tract

d. jaundice

Supplies that are needed for collecting a 24-hour urine specimen include all of the following, excepta. specipan, bedpan, or urinalb. signs to remind the patient that a 24-hour collection is being performedc. sterile gloves and transparent dressingsd. 24-hour urine collection container

e. nonsterile gloves

c. sterile gloves and transparent dressings