A practical nurse is instructing a female client on how to obtain a midstream (clean-catch) urine specimen for culture and sensitivity. To prevent contamination of the specimen and reduce the risk of inaccurate diagnostic laboratory results, arrange the following steps in the correct chronological order.
- 1Perform hand hygiene and open the sterile specimen container.
- 2Cleanse the urethral meatus using front-to-back motions with antiseptic wipes.
- 3Instruct the client to initiate the urine stream directly into the toilet.
- 4Pass the sterile specimen container into the active urine stream to collect the sample.
- 5Remove the specimen container before the flow of urine completely stops.
Answer
The correct sequence begins with hand hygiene, followed by cleansing the meatus, initiating the urine stream into the toilet, catching the sample midstream, and removing the container before the stream stops.
Obtaining a midstream clean-catch urine specimen requires a specific procedural sequence to reduce the risk of false-positive diagnostic laboratory results. Hand hygiene and equipment preparation must come first to maintain sterility. Cleansing the meatus from front to back removes surface bacteria. Initiating the urine stream into the toilet flushes the lower urethra of resident flora. The sterile cup is then passed into the midstream to collect the most accurate sample of bladder urine. Finally, removing the cup before the stream stops prevents contamination from terminal drops of urine.
Step-by-Step Solution
Key Concept
Proper technique for obtaining a clean-catch midstream urine specimen