Urine dipstick, urinalysis, culture?!

[amysnurse]

Hi! I work in a family physicians clinic and am stumped. Can someone please explain to me the difference between a urine dipstick, urinalysis, culture and a urine drug screen? We are often asked to perform these on patients and I don't know the difference between them? What gets sent off? What doesn't? How the patient performs them, like sterile catch, etc? Thanks!!

[Here.I.Stand, BSN, RN]

You should ask at work. At my hospital, all nursing does is collect the sample and send it to the lab. If we need a sterile sample for a culture, we collect a sample from the port if they have a foley/straight cath if they don't. (I'm an ICU nurse, so very few pts can give a clean catch.) Your facility may be different...hence my advice to ask at work.

[AceOfHearts<3]

I'm in the ICU as well and we don't do urine dipsticks- the emergency room does those. You dip a specialized stick in the urine and the color changes- you then match the color to the color coded key.

Urinalysis is done at our lab- tells us things like if there is glucose, protein, blood, white blood cells, etc. in the urine which can indicate various things- a UTI, diabetes, etc.

We frequently send a urinalysis with a culture hold. Basically if the the urinalysis indicates a possible infection they will culture the urine to see what grows and what antibiotic to use. If the urinalysis indicates a culture is not needed, then the culture is not done.

Urinalysis and cultures should be clean catches- the peri area should be cleansed prior to the void. The patient should start to void and the collection of urine should start mid-void. If the patient is not capable of giving a clean catch then they should be straight cathed. A clean and sterile catch is important so a patient is not unnecessarily treated with antibiotics. The only way to get a truly sterile sample is with a catheter- either a straight cath or from the port of a clamped foley like Here.I.Stand indicated.

A urine drug screen is not looking for bacteria and does not need to be a clean catch. A urine drug screen looks for metabolites that are excreted in the urine and can indicate classes of drugs (not specific drugs) that a patient may be taking or may have taken.

What gets sent out vs. done in the office will vary by office.

[amysnurse]

Thanks!

[amysnurse]

Thanks so much for your detailed answer! It helped alot!