A client started a 24-hour urine collection test at 6:00 AM. The unlicensed assistive personnel (UAP) reports discarding a urine specimen of 250 mL at 10:00 AM by mistake but adding all specimens to the collection container before and after that time. What action should the nurse take?
A)Add 250 mL to the total output after the 24-hour urine collection is complete tomorrow morning
B)Discard urine and container, and restart the 24-hour urine collection tomorrow morning
C)Discard urine and container, have client void, add urine to new container, and then restart test
D)Relabel the same collection container, and change the start time from 6:00 AM to 10:00 AM

Question

A client started a 24-hour urine collection test at 6:00 AM.  The unlicensed assistive personnel (UAP) reports discarding a urine specimen of 250 mL at 10:00 AM by mistake but adding all specimens to the collection container before and after that time.  What action should the nurse take?
A)Add 250 mL to the total output after the 24-hour urine collection is complete tomorrow morning
B)Discard urine and container, and restart the 24-hour urine collection tomorrow morning
C)Discard urine and container, have client void, add urine to new container, and then restart test
D)Relabel the same collection container, and change the start time from 6:00 AM to 10:00 AM

Quizplus · Accepted Answer

Timed urine collection tests are usually done to assess kidney function and measure substances excreted in the urine (eg, creatinine, protein, uric acid, hormones). These tests require the collection of all urine produced in a specified time period (a crucial step) to ensure accurate test results. The proper container (with or without preservative) for any specific test is obtained from the laboratory. The collection container must be kept cool (eg, on ice, refrigerated) to prevent bacterial decomposition of the urine. Not all of the client's urine was saved during the collection period. Therefore, the nurse or UAP must discard the urine and container and restart the specimen collection procedure. Although a 24-hour urine collection can begin at any time of the day after the client empties the bladder, it is common practice to start the collection in the morning after the client's first morning voiding and to end it at the same hour the next morning after the morning voiding (Option B). (Option A) Adding 250 mL to the total output when the test is completed is not an appropriate action as the actual urine output from the 24-hour period is needed for accurate results. (Option C) To start the collection period, the nurse asks the client to void and discards this specimen (it is not added to the collection container). The 24-hour period starts at the time of the client's first voiding. (Option D) Relabeling the same container and changing the start time from 6:00 AM to 10:00 AM is not an appropriate action. The container would include part of the urine produced in a 28-hour period, and the test results would be inaccurate. Educational objective: It is common practice to start a 24-hour urine collection test at the time of the client's first voiding in the morning. If any urine is discarded by accident during the test period, the procedure must be restarted. All produced urine should be placed in the same container and kept cool (on ice).

A Client Started a 24-Hour Urine Collection Test at 6:00