Page 1821 - Saunders Comprehensive Review For NCLEX-RN

concentrated urine) occurs with
insufficient fluid intake, decreased
renal perfusion, or increased ADH.
f. A decrease in specific gravity (less
concentrated urine) occurs with
increased fluid intake or diabetes
insipidus; it may also indicate renal
disease or the kidneys’ inability to
concentrate urine.
H. Urine culture and sensitivity testing
1. Description: A urine test that identifies the presence of
microorganisms (culture) and determines the specific
antibiotics to treat the existing microorganism
(sensitivity) appropriately
2. Interventions
a. Clean the perineal area and urinary
meatus with a bacteriostatic solution.

b. Collect the midstream sample in

a sterile container (clean catch
specimen); if the client is unable to
obtain a clean catch specimen, a
specimen obtained by straight
catheterization may be prescribed.
c. Send the collected specimen to the
laboratory immediately.
d. Identify any sources of potential
contaminants during the collection of
the specimen, such as the hands, skin,
clothing, hair, or vaginal or rectal
secretions; if contamination occurs, the
specimen is discarded and a new
specimen needs to be collected. Urine
from the client who drank a very large
amount of fluids may be too dilute to
provide a positive culture.
I. Creatinine clearance test
1. Description
a. The creatinine clearance test evaluates
how well the kidneys remove
creatinine from the blood, and is an
estimate of glomerular filtration rate
(GFR).
b. The test includes obtaining a blood
sample and timed urine specimens.
c. Blood is drawn when the urine
specimen collection is complete.
d. The urine specimen for the creatinine

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