Evaluation of Urine 24-hour Volume Test (Nursing)

00:00 Okay so much talk about urine.

00:03 Let's talk about why urine creatinine is also called a creatinine clearance test.

00:09 Oka now that's when we have comparison but what do you think? What are your thoughts on that? Why do you think a urine creatinine is also called a creatinine clearance test? Okay, because it measures how much creatinine has passed through or by the kidneys into the urine.

00:27 That's why they call it a creatinine clearance test.

00:31 Remember to get great results.

00:32 We've got to have consistent creatinine and we've got to compare the blood to the urine.

00:38 Now here's a urine 24-hour volume test.

00:41 You may see this ordered with different kind of wording.

00:43 You may just called a 24-hour urine test, but I want you to keep in mind there's a range of normal values.

00:51 These are not ones you're probably familiar with or that you seen much in your textbooks.

00:55 But if we look at a 24-hour urine sample a complete one that only involves 24 hours, you can see what the values are there for males.

01:05 Look at the values for females.

01:08 Okay notice the females are slightly different from males and you know why at this point.

01:14 Now creatinine clearance is calculated these are the numbers that you will most likely see in your practice.

01:21 And remember these are the normals we talked about earlier in the presentation.

01:25 Okay so everybody with me? We're talking about a creatinine clearance test.

01:30 We need a urine sample for 24 hours.

01:32 You compare it to a venous sample because we're looking at how much of that creatinine was pulled out of the blood.

01:38 And dumped out into the urine.

01:40 Got that! We know that males have a little bit higher levels than females.

01:45 Good.

01:46 All right, let's keep going.

01:47 Let's talk a little bit about that 24-hour urine test.

01:50 Now we have another video.

01:52 That's walks you through all the steps.

01:54 So if you got an order for a 24-hour urine and we've got very clear steps for you to see.

01:59 But I want to just kind of bring up a couple things while we're here in this video.

02:04 Now at the time the collection is started.

02:06 Usually we started about 8 a.m. Am but it just depends on where you are.

02:10 This is what a label may look at a facility where you're doing this collection, or a label that you would send home with a patient if they're doing this at home.

02:19 So let's say we start at 8 a.m.

02:21 You're going to ask the patient to empty their bladder completely but don't save that urine.

02:26 Okay, so if I'm starting at 8 a.m.

02:28 I'm going to go to the restroom empty my bladder, but I'm not going to save that specimen, but I'm going to write that time down in the date on the start line.

02:36 So that's how I fill out the first part of the label, then whoo-hoo for the next 24 hours.

02:42 I need to save all the urine and add it to the same container.

02:46 Here's the part where people get a little uncomfortable because you got to keep that container refrigerated.

02:51 You can walk them through how to do that at home.

02:54 Most people are not thrilled about that part in the hospital will have it in a special container with some ice surrounded and everybody knows that's a 24-hour sample, but you have to keep it iced or cold because you don't want to limit you want to limit bacterial growth.

03:10 So that's the goal.

03:12 Start at a time, empty your bladder, note that time don't save that sample.

03:17 Then when the next time you do pee you put that in the container and you've got to keep it cold.

03:23 Now exactly and we're not kidding exactly 24 hours after the first one, you want to empty your bladder and add that portion to the container.

03:33 It doesn't matter if you feel like you need to go you think you need to go, you don't need to go, you need to get everything out of your bladder that's left at that 8 a.m. time slot.

03:42 Then you enter the date and time on the end line put the name on it, identify it and you're going to send it to lab or bless you if you had to do this at home, you're going to drive it into the lab or your physician's office.

03:55 So when you see someone talk about a 24-hour urine sample, empty the bladder, note the time.

04:02 And everything after that you keep adding to the sample.

04:07 Keeping it cold or refrigerated.

04:10 At 8 a.m., the next day, 24 hours later.

04:13 You need to try to use the restroom again to empty everything out possible from your bladder.

04:19 Then that is a complete 24-hour sample.

04:24 So why does it have to be exactly 24 hours? I know it's kind of annoying is it most of us don't like to be told what to do, but this is why it's really important.

04:35 If that sample doesn't reflect accurately 24 hours.

04:39 Your lab results are not going to be accurate.

04:42 So if you get less than 24 hours worth of urine, that's an incomplete urine collection and that way your creatinine level the elimination of it may be too low.

04:52 Not accurate.

04:54 Well, what if you go just a way bit over 24 hours, maybe you sleep in, you're going to have to start again because that could cause, that could show us a too higher rate of elimination of creatinine.

05:05 So it's got to be set your alarm clock 24 hours strict of how much urine your body put out in order to get the most accurate results.