Question

A charge nurse overhears a newly licensed nurse providing instructions to a female client on the proper steps to collect a midstream urine specimen. Which of the following statements made by the newly licensed nurse requires the charge nurse to intervene?

A. "It will be easier to use your non-dominant hand to spread the labia." Rationale: The client should use her nondominant hand to provide access to urethral meatus, leaving the dominant hand to maneuver the specimen container.
B. "Use the provided towelette to cleanse the area by moving in a back-and-forth motion." Rationale: The client should use a new towelette each time to cleanse from an area of least contamination (front) to an area of greater contamination (back).
C. "Start the flow of urine before passing the container under the stream to collect the specimen. Rationale: This action prevents contamination of specimens by allowing the first flow of urine to wash away dirty surface area before securing a urine sample.
D. "Remove the specimen container before stopping the stream of urine." Rationale: This action prevents the introduction of vaginal or perineal area bacteria into the specimen.

Answer 1

The charge nurse should intervene when the newly licensed nurse instructs to clean the area with a back-and-forth motion using the towelette. Proper urine specimen collection requires wiping from front to back to prevent contamination.

Step-by-step explanation:

The statement from the newly licensed nurse that requires intervention by the charge nurse is: "Use the provided towelette to cleanse the area by moving in a back-and-forth motion." The correct technique for collecting a midstream urine specimen involves using a towelette to cleanse the urethral area by wiping from front to back, not back-and-forth. This is to minimize contamination of the specimen with microorganisms that are normally present in the area around the anus. The correct steps include using the nondominant hand to spread the labia, starting to urinate a small amount into the toilet to wash away any contaminants, then moving the collection container under the urine stream to collect the midstream urine, and removing the container before finishing urination.