a. Review the patient’s clinical record to verify the physician’s order and identify the purpose of the 24-hour specimen.

(1) Urine is routinely collected for 24 hours in order to obtain a substantial quantity of urine for measuring solutes that are normally excreted in small amounts (such as hormones, proteins, and electrolytes).

(2) Urine is also collected for 24 hours in order to test excretion rates in one day’s function.

b. Some tests require dietary restrictions prior to and/or during the exam. Be certain these restrictions are followed.

c. Assemble the necessary equipment.

(1) Twenty-four hour urine collection container. (Container should have required chemical preservatives inside, as appropriate for test.)

(2) Urine collection pan/urinal.

(3) Intake and output worksheet.

(4) Signs stating “twenty-four hour urine collection in progress.”

(5) Urine specimens cup (if initial specimen is required).

d. Approach and identify the patient.

e. Explain the procedure and its purpose to the patient. Be certain the patient understands what must be done.

f. At the designated time on the designated day, begin the collection.

(1) A twenty-four-hour collection normally begins in the early morning, at the time of the patient’s first morning void.

(2) Instruct the patient to empty his bladder. (Sometimes, a specimen is collected at this time. If not required, discard the urine.)

(3) Record the time the patient emptied his bladder in the patient’s chart and on the twenty-four hour collection container. This is the start time.

g. Instruct the patient that all urine voided for the next 24 hours must be saved and placed into the twenty-four hour collection container.

(1) Provide the patient with a urine collection pan or urinal, as appropriate.

(2) Instruct the patient to notify the nursing staff each time he urinates into the collection pan, so the urine can be measured and added to the twenty-four hour collection container.

(3) Record each voiding on the I & O sheet, if required.

h. Post signs saying ” twenty-four hour urine collection in progress” on the patient’s chart, the bed, the door, and in the bathroom, as appropriate.

i. Once the first urine specimen has been placed into the twenty-four hour collection container, the container must be kept on ice or in a specimen refrigerator (never, a food refrigerator).

j. The following day, at the same time the test was initiated, ask the patient to void one last time. This specimen is added to the twenty-four hour collection container.

k. Record date and time of completion on the container and in the patient’s chart. Remove “24-hour urine collection in progress” signs.

l. Complete the appropriate laboratory request slips and transport the specimen to the laboratory within 30 minutes of completion.

m. Record the procedure and significant nursing observations in the patient’s clinical records.