Urine specimen collection in Pediatrics

Urine specimen collection in pediatrics is a vital diagnostic procedure used to detect infections, assess kidney function, and monitor hydration or metabolic conditions. The method varies by age, developmental stage, and clinical need.

Types

1. Clean catch
2. Urine culture
3. Midstream specimen of urine

Preparation

• Explain the procedure and its reason to the child and parents.
• If the child is old enough, give adequate guidelines and allow collecting the urine sample.

Precaution

The skin of the genital area should be cleansed with a mild disinfectant to prevent contamination of the urine specimen or irritation of the delicate membranes of the area.

Procedure for Urine specimen collection

Wash hands and don gloves.

• The area around the vulva is wiped and dried thoroughly with the sterile swabs and towels, working from the front to back.
• If the child is unable to use the toilet, the bedpan is placed beneath her.
• When the urine begins to flow, the first part is allowed to pass into the toilet or bedpan.
• Then the sterile container is placed in position and filled with the midstream portion of the urine.
• The reminder of urine is then allowed to pass into the toilet or bedpan.
• Place the lid securely on the cup.

•  For male child.
• Retract the fore skin.
• The area around the penis and the urethra is wiped and dried thoroughly with the sterile swab and towels working from front to back.
• If the child is uncircumcised, the fore skin should be held back during the complete procedure to prevent the skin contaminating the sample.
• The child then begins to pass urine into the toilet or urinal.
• The sterile container is placed in position and filled with the midstream portion of the urine taking care that penis does not touch the sides of the container.
• The remainder of the urine is then allowed to pass into the urinal.
• The lid is placed securely on the cup.

• For infants
• The genitals are cleansed and dried thoroughly using the sterile wipes and towels.
•  A sterile collection bag is placed over the area with the adhesive tape firmly stretched on to the baby’s skin.
• A fresh diaper is put on the child over the collecting bag and checked frequently for the child having passed urine into the bag.
• When the specimen is obtained, it is poured into a sterile container and sent immediately for testing.

• For the uncooperative child
• Give the child water or other fluids to drink.
• Clean the external genitalia.
• The child can be seated on the lap of the mother/nurse who should then encourage the child to urinate and collect as much as urine as possible in a sterile container.

Note: urine collected from the diaper is not recommended for laboratory testing since contamination from the diaper material may affect the results.

Aftercare

• The child should be made comfortable.
• Praise the child for cooperation.
• All swabs, towels, and gloves should be disposed in appropriate container.
• The nurse should wash the hands and dry thoroughly.
• The specimen should be sent for testing as quickly as possible. Speed in testing the sample is essential in order to obtain an accurate result.

Special Considerations

• Avoid collecting urine from diapers—it’s not suitable for lab testing.
• For infants, hydration and timing (e.g., after feeding) can help prompt urination.
• Always use sterile containers and follow infection control protocols.

REFERENCES

1. Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
2. Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
3. Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
4. Marcia London, Ruth Bindler, Principles of Paediatric Nursing: Caring for Children, 8th Edition, 2023, Pearson Publications, ISBN-13: 9780136859840.
5. Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/

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