Collection of specimens : Urine & Stools

      • Urine 
        • Urine collection bags
          • For infants and toddlers who are not toilet trained, special urine collection bags with self-adhering material around the opening at the point of attachment may be used. 
          • To prepare the infant, the genitalia, perineum, and surrounding skin are washed and dried thoroughly because the adhesive will not stick to a moist, powdered, or oily skin surface. 
          • The collection bag is easiest to apply if attached first to the perineum, progressing to the symphysis pubis. 
          • The bag is checked frequently and removed as soon as the specimen is available, because the moist bag may become loosened on an active child.
          • Clean-catch specimen refers to a urine sample obtained for culture after the urethral meatus is cleansed and the first few milliliters of urine are voided. (midstream specimen). 
          • For a 24-hour collection, collection bags are required for infants and smaller children. 
          • The collection period for a 24-hour collection always starts and ends with an empty bladder. At the time the collection begins, instruct the child to void and discard the specimen. All urine voided in the subsequent 24 hours is saved in a container with a preservative or is placed on ice. 24 hours from the time the pre-collection specimen was discarded, the child is again instructed to void, the specimen is added to the container, and the entire collection is taken to the laboratory.
        • Clean catch specimens
          • Refers to a urine sample obtained for culture after the urethral meatus is cleansed and the first few milliliters of urine are voided (midstream specimen). 
            • In girls, the perineum is wiped with an antiseptic pad from front to back. 
            • In boys, the tip of the penis is cleansed.
        • 24-hour collection
        • Bladder catheterization and other techniques
          • Use distraction to help the child relax (e.g., blowing bubbles, deep breathing, singing a song).
          • Use lidocaine jelly to anesthetize the area before insertion of the catheter. 
            • EMLA cream (a eutectic mixture of lidocaine and prilocaine) or LMX cream may lessen an infant’s discomfort as the needle passes through the skin for suprapubic aspiration, but care should be taken that the site is thoroughly cleansed and prepped before the procedure.
          • Children often become agitated at being restrained for either procedure. Use comfort measures through touch and voice, both during and after the procedure, to help reduce the child’s distress.
      • Stool specimens
        • To obtain a stool specimen, place plastic wrap over the toilet bowl before defecation. Use a tongue depressor or disposable spoon or knife to collect the stool.

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