If No Luck Trying to Straight Cath, Obtain Urine Sample from the Wet Pad?

[Zen123]

The outgoing nurse reports that she had trouble straight cathing a resident. Supervisor told her you can obtain the urine sample using a syringe to draw urine from the wet pad. (?) I've never heard of that, but would be great especially with difficult residents. The res. is incontinent. The order is to dip urine/ straight cath, send urine for UAC&S if Positive.

I can see doing a urine dip from the wet pad, but can u send the sample collected from the pad for UA C&S?

[systoly]

I highly doubt the lab would run a C&S on that specimen.

[tewdles, RN]

As has been stated...you cannot obtain a C&S from a specimen "sucked" out of a pad. Elderly women can be challenging to cath, their perineal landmarks are not as clear cut as in a pedi or young woman. Sometimes the urethral meatus is "prolapsed" into the lady parts and is not even visible. You may have to catheterize her lady parts and leave that cath in place to assist you with visualization. Make sure that you have plenty of light and if the patient cannot help you with good position of her hips and legs, ask for a co-worker to assist. For some patients, it is best to cath them in a sidelying position rather than supine. Good luck.

[K.P.A.]

Common sense it's NG for C&S. Utility depends on what you're assessing for.

[NamasteNurse, BSN, RN]

At our nursing home we sometimes will put a small cup in place inside a residents brief...you have to check it every half hour

[XingtheBBB, BSN, RN]

Obviously it's not sterile for a culture but I have gotten ketone strip samples that way... don't try to "suck" it out of a pad with a syringe... just tear a little piece of the wet fluff out of the pad and put it inside the syringe, push the plunger until it squeezes out the drops.

[Virgo_RN, BSN, RN]

What is the urine sample for?

[Otessa, BSN, RN]

The outgoing nurse reports that she had trouble straight cathing a resident. Supervisor told her you can obtain the urine sample using a syringe to draw urine from the wet pad. (?) I've never heard of that, but would be great especially with difficult residents. The res. is incontinent. The order is to dip urine/ straight cath, send urine for UAC&S if Positive.

I can see doing a urine dip from the wet pad, but can u send the sample collected from the pad for UA C&S?

Um, isn't it supposed to be a sterile specimen-never heard of this one before...

otessa

[tatara]

Urine C&S sample from wet pads? No way. Your effort will be useless. That idea from a supervisor? Are you sure she knows what she's talking about or did she read and understand the order?:loveya:

Extreme nursing ingenuity is needed. Very challenging.

In our facility we use condom cath, but still, not a sterile means of obtaining specimen. I would encourage patient to drink plenty of fluids if allowed, wrap feet with wet towel or dip the pinky in cold water and then instruct the watcher to "watch out" for the patient to pee and catch specimen mid stream. It usually works when the watcher is as determined as the nurse.

[Bobbkat]

I've done this in peds, as a student. The nurse gave me instructions on how to do it, which my clinical instructor verified. We had to do frequent UA on the patient, no cultures or anything. I had to put cotton balls in his diaper, and then put the cotton balls in a syringe and squeeze the urine out onto the strip for the machine. Apparently you can't just use the diaper because the absorbent stuff in the diaper interferes with the results. For this patient, they were worried about a tumor/neuro problem, and were mostly worried about making sure that his renal function wasn't being impaired as a result, so really it was just for trending, I suppose.

[nursel56]

This reminds me fo the "old days" when we drew all specimens from a diaper. It was explained to me that new diaper materials interfered with current testing, so we stopped sending them. If Peds or NICU try bagging, if adult try new cath.

That's curious to me. I worked at a Children's Hospital in the old days and I've never seen anyone get a specimen that way. Especially since we used cloth diapers on most of the babies back in the day. A point I find amusing. The only babies other than NICU we used disposables were strict I&O, we weighed the diapers, then weighed them again after the child voided. Where and how did you see this done?

[Zen123]

Thanks For all The Feedback. I'm certainly going to bring this up.

The Supervisor

said they used to do this when she worked at the NICU - draw urine specimen from the wet pad to urine dip test for uti. I work in a LTC skilled unit and I couldn't imagine...

When I heard of it I to was like, Seriously?!!!

Thanks again.

[cjcsoon2bnp, MSN, RN, NP]

I'm sorry but I wouldn't do it. Its not sterile and I don't think its good practice.

!Chris