Sep 3, 2008

How to Help a Female Child Provide a Urine Sample



from wikiHow - The How to Manual That You Can Edit

For ages urine has been used to tell us about out health. Routine urine testing is frequently a part of well girl medical care and to diagnose illness or disease. In order to test urine for bacteria, a clean catch (otherwise known as midstream) sample is required. Due to girl’s anatomy, there is a good chance that foreign bacteria may contaminate the urine sample resulting in false test results if specific procedures are not followed. False positive test results are common and result in needless use of antibiotics or more invasive medical testing. Parents are the ones left to assist their daughters with this.

Steps


  1. Lay out a couple paper towels to provide a clean area to set the specimen cup, wipes or other supplies. This should be easily reached from the toilet and not get splashed when washing hands.
  2. Have or help your daughter undress. Since she will need to spread her legs apart as wide as possible, she should remove her pants, shorts and panties. However, some girls may be able to spread their legs wider with their pants/panties at their ankles.
  3. You may want to push up any long shirt sleeves to keep them out of the way (yours and hers).
  4. Both of you should wash your hands. Even if you are collecting the sample, washing hands involves her in the process. Be sure to lather between fingers, both the front and back of hands all the way up to or above the wrists for 20 seconds. Rinse thoroughly. Turn off water using a paper towel to protect your clean hands. Avoid touching anything unnecessary such as the wall, your clothing, and so forth until done.
  5. Have you daughter straddle the toilet with her legs apart as far as possible. One guide suggests having her sit facing the wall (opposite direction) to encourage her to keep her legs wide apart. However, the cut out portion in the front most commercial toilet seats might provide slightly easier access.
  6. Open the specimen container. Place the inside of lid facing upward on the paper towel protected surface. Do not touch the inside of the lid or inside of the specimen container. It is best to keep your fingers away from the rim when handling the container.
  7. Have her pull up or hold up her shirt so that it is up and out of the way.
  8. Put on gloves if provided or you are instructed to do so.
  9. With her legs positioned widely apart, have her lean back slightly (towards her back)to provide easier access.
  10. Using your index and middle finger of one hand gently separate her labia (the folds of skin around the opening where the urine comes out). Your fingers will be separated like you are making an upside down letter V. Alternatively, you might be able to use your thumb and index finger. Separating her labia majora (large outer lips) in this fashion should separate her inner labia minora. If she is older or has larger labia minora, be sure hold these apart using the same finger described above. If your daughter is able, she could hold her own labia apart using the above described method. Make sure to keep the labia separated for the rest of the procedure.
  11. Cleansing over her urinary meatus (opening of her urethra where urine comes out) and the surrounding area has been found to reduce false positive results. In addition to cleansing for providing a clean urine sample, she should be practicing good hygiene when toileting and bathing. Directions for cleansing her vary. Be sure to follow the directions provided to you.
  12. If the directions are vague, these common steps are effective when using antibacterial wipes. With the first of the three wipes wipe slowly from front to back over the middle of her exposed area. Be sure to wipe the ending of her clitoral hood and the area between her inner labia minora passing slowly and directly over her meatus (opening where the urine comes out), using one stroke from top to bottom. Discard the wipe. Then repeat this wiping using a new wipe just to one side of her urinary meatus. Using the last wipe, wipe just to the other side of her meatus.
  13. Use the wet wipe to rinse her labia and meatus down the center.
  14. Have her lean slightly forwards (towards her front) while keeping her labia separated. This will aim her urine stream down into the toilet.
  15. While still holding the labia apart, have her start to urinating (peeing) into the toilet. If she has difficulty, try turning on the water faucet.
  16. After she has urinated a small amount, position the cup under the stream. She should continue to urinate (not stop and/or restart her stream). Do not to touch the cup's rim to her skin. Moving the cup into her stream while she is peeing is a bit messy and your fingers will get wet if this is done correctly.
  17. Take the cup away when it's about 1/3 full to 2/3 full. Do not over flow. Again she should continue to pee while the cup is taken out of her stream. If the cup is even a 1/4 full and the force of her stream lets up, remove the cup before she stops peeing.
  18. Once the specimen cup has been removed, allow her to finish peeing in the toilet. If she wishes, she may stop and restart her stream when her labia is let go.
  19. Place the cover tightly on the specimen cup without touching the rim or inside of the lid. You may wipe off any urine from the outside of the cup. Set cup in safe place. Sometimes there is a special door so that you may leave the specimen from the lab to retrieve from the other side.
  20. If needed, help her wipe any urine from her legs, etc. This is natural opportunity to review the importance of always wiping from the front to back.
  21. This is a great opportunity to have her look at the color of her urine. If it is dark in color, remind her that she needs to be drinking more water. If it is light or clear in color, praise her for drinking plenty of water.
  22. Help her dress if needed.
  23. Finally, both of you should wash your hands again. Don’t forget to take the urine sample if it needs to be turned in elsewhere.
  24. Clearly label the container as to time and date.


Tips


  • When assisting your daughter, help promote her independence. Assist as much as needed. Depending on her age and experience, she may need you to perform all steps listed or she may need you to give her some verbal direction.
  • If your daughter has labial adhesions, check with your health care provider for specific directions. If there are no specific directions, make sure her bladder is full prior to taking the sample. Follow the directions above except for separating her inner labia minora. Allow her pee at full force for a longer period of time prior to placing the specimen cup in her stream. This will help rinse the area under her labia minora.
  • If collecting a urine sample at home and you do not have a specimen cup, boil a small glass jar and lid for 7-10 minutes. Allow the jar and lid to air dry in a clean place. Because of the heat it should dry rapidly. Do not dry it with a towel or paper towel. Be careful not to burn yourself.
  • If collecting a urine sample at home and do not have antibacterial wipes, use 3 wet paper towel pieces with several drops of anti bacterial soap. An additional clean wet paper towel piece could be used for rinsing.
  • If collecting a urine sample at home, place it in a refrigerator or cool place until you can take it to the lab.


Things You'll Need


  • 3 antibacterial/soapy wipes for cleansing
  • 1 wet wipe for rinsing
  • 1 sterile collection container (specimen cup)
  • Labels


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Sources and Citations





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