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.