Urine Collection: A Comprehensive Guide for Conducting Urinalysis in Medical Offices

Part A: Urine Collection and Testing in Medical Offices

PART A:
1.Urine collection is a very utilized skill in the Medical Office. Often, when a MOA is assessing the client, the client will have complaints that would prompt the MOA to conduct a urinalysis. In the space provided, list 3 possible complaints that the client may have to indicate the need to conduct a urinalysis in the medical office.

2.The MOA is responsible for instructing the client how to collect a midstream urine through patient teaching to ensure the sample collected is not contaminated. Contamination of the urine sample will provide inaccurate results when tested. In the space provided please write how you would instruct the client to collect a midstream urine sample to avoid contamination and list the supplies you would provide the client

3.After the client has provided you with you the sample you will inspect the urine with your senses for physical properties. What are the 3 physical properties that you will assess for and what do they indicate?

4.After inspecting the urine for physical properties, the MOA will now test for chemical properties. List the chemical properties that are tested and explain what each determine

5.Which chemical properties when showing a positive result, would prompt you to ask the physician if they would like you to prepare a sample to be sent to the lab for a C&S?

6.C&S is a test conducted in the laboratory.
a)What does the abbreviation C&S stand for?
b) What is C&S testing for in the lab?

7.What supplies are needed to properly conduct a urine analysis and prepare a sample to be sent to the Lab?

8.Calgary Lab Services uses several different requisitions for various lab testing. Which requisition(s) will you choose?

9.What is the vital information, including the test(s) checked off that must be included on the requisition, to avoid the sample being returned?

10.Where will your sample of urine, to be sent to the Lab, be stored until it is picked up by Calgary Lab Services?

PART B: TASK ANALYSIS Complete on the PDF fillable task analysis provided.
A task analysis is a step-by-step guide for completing a skill. A task analysis has been created for you to conduct an in-office urinalysis. Using this task analysis, provide a rationale for each step that is in bold.

PART C: CASE STUDY Document the encounter(s) on the fillable PDF progress note provided. 
On September 7 when your walk-in clinic for Dr. White, opened at 0800, a patient entered the facility. Upon registering Mrs. Laura Patrick, born March 10, 1977. You asked the patient her reason for the visit, she said he was having a difficult time urinating, experience pain while urinating, and feeling pain in her abdomen.  You asked the patient to provide a urine sample and gave her instructions to do so. In your opinion, you thought the patient had a urinary tract infection or a bladder infection. She did seem annoyed with you though after asking for urine sample and said she just went to the bathroom. You gave her a glass of water and asked her to try, stating you only needed 10 mL in the specimen cup.  She seemed annoyed with you and you may have caught her rolling her eyes at you when you were provided her instructions how to take a mid-stream catch.
You were able to complete the registration process with her while she drank the water you provided. You showed her where the bathroom was located and asked her to bring the sample to you when she completed. She returned to your desk 10 min later with urine in the cup. The urine was a dark amber color. You notified the nurse that the patient was ready to be roomed. About 15 minutes later the nurse told you she was busy and requested you to take the patient to exam room 5. She asked you to monitor the patient; requesting her vital signs to be taken until she returned. When you entered the room, the patient was lying on the exam table.
It took you a few tries to get the blood pressure, but you managed to take it from the right arm. You had a difficult time palpitating the pulse because it was weak, difficult to hear and seemed to skip a beat. Her respirations weren’t deep enough to cause her belly to rise and fall visibly, so this also took you a few tries to count correctly. You measured her temperature with a temporal artery thermometer.
When the nurse returned you asked the nurse to double-check the vital signs because you were not confident about your recordings. The nurse requested that you conduct a urinalysis on the specimen the patient provided. When you opened the specimen container you noticed a bad smell and noted the urine was a very dark amber color. The dip stick analysis showed a pH of 6, specific gravity of 1.103, 3+ leukocytes, positive for nitrates, and 1+ for blood. All other indicators were negative. You notified the nurse of the results. The nurse asked you to send a sample to the lab for a culture and sensitivity and microscopic urinalysis. The nurse asked you to monitor the patient until the physician arrived due to the patient having nausea.
The readings you obtained: systolic blood pressure 162, diastolic blood pressure 90, radial pulse 120 beats per minute, respirations were 22 and the temperature was 38.2 degrees Celsius.