![]() ![]() Have the patient collect each voiding in a smaller container and carefully pour the urine into the 24-hour container to avoid any possible acid burns to the patient (make sure the patient understands the hazard presented by the acid preservative). Important Note: For those analyses requiring the addition of 6N HCl, add the acid at the start of collection. (See section on FROZEN SPECIMENS.)īecause proper collection and preservation of 24-hour urine specimens are essential for accurate test results, patients should be carefully instructed in the correct procedure. Pack in dry ice for transport to the laboratory. If a frozen specimen is required, freeze the urine immediately after collection. See Urinalysis test for specific information. Note: Specimens for Urinalysis must be submitted in a yellow/red swirl-top preservative tube. This information is included as part of the specimen requirements for the individual tests in the General Test Listing section. For others, there are drug that must be avoided prior to obtaining the specimen. For some of these tests, there are dietary restrictions that must be observed. For urine chemistry tests, the 24-hour urine collection is the usual standard. Note the time of collection of the specimen on the test requisition and on the label of the container. Urine for pregnancy testing should be first morning void, or a random specimen with a specific gravity of at least 1.010. Submit a first morning voided specimen whenever possible. To reduce contamination, the specimen submitted for urinalysis should be a clean catch “mid-stream” sample. This specimen is preferred because it has a more uniform volume and concentration, and its lower pH helps preserve the formed elements. Most reference values are based on analysis of the first morning voided urine. The normal composition of urine varies considerably during a 24-hour period. Transfer the requested volume into the labeled urine transport vial. Measure and record this volume on the test request form and on the urine transport vial (see Pediatric Specimen Tubes below). Collect all urine for the next 24 hours so that the morning urine void on the second day is the final collection. On the day of the collection, discard the first morning urine void, and begin the collection after this void. The patient (or responsible individual) should be cautioned that the preservative may be toxic and caustic, and not to spill or discard the preservative. When the 24-hour urine output is less than 1 liter, 4 grams of boric acid can be used when boric acid is the specified preservative or 10 mL of 6N HCl can be used when HCl is specified. If a preservative is required, it is important that the designated preservative be in the urine collection container at the start of the collection. Record on the test request form any medications that the patient is receiving. ![]() They also have great promise for public health monitoring, policy development, and resource allocation.” However, they add, “women can and have been arrested for positive drug screens with even preliminary results used to remove children from custody, before rigorous confirmatory testing is completed.Many urine chemistry tests require a 24-hour collection. ![]() In a recent review in Frontiers in Pharmacology, 3 specialists note, “Better screening tests have great potential to improve neonatal and maternal medical outcomes by enhancing the speed and accuracy of diagnosis…. Nonetheless, there are ethical considerations even in universal screening. “Routine screening should rely on validated screening tools, such as questionnaires, including 4Ps, NIDA Quick Screen, and CRAFFT (for women 26 years or younger).” 1 In a 2017 joint Opinion, ACOG and ASAM endorsed universal screening for substance use as “a part of comprehensive obstetric care and should be done at the first prenatal visit in partnership with the pregnant woman.” Universal screening, rather than selective screening based on risk factors, is recommended to avoid bias and stigma. Screening for substance use in all pregnant women is recommended by both the American College of Obstetrics and Gynecology (ACOG) and the American Society of Addiction Medicine (ASAM) in order to provide women and their fetuses and children with the best care during and after pregnancy. ![]()
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