Home OSCE Practical Examination MID-STREAM SPECIMEN OF URINE, NMC Osce Clinical Station

MID-STREAM SPECIMEN OF URINE, NMC Osce Clinical Station

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– Once you’ve identified the patient and introduced yourself, engage in a discussion with them about the procedure and obtain their consent.

– Instruct the individual on how to conduct the MSU (for women, gently separate the labia and cleanse the meatus with soap and water from front to back; for men, retract the foreskin and clean around the meatus). Urinate a small amount and then halt the flow of urine. Position the specimen pot a few centimetres away from the urethra and urinate until the cup is roughly half full.

PROCEDURAL STEPS

– Cleanse your hands using alcohol-based hand rub or wash them with soap and water, adhering to WHO guidelines.

– Confirm that all necessary equipment for the procedure is accessible and, if applicable, sterilized (ensuring that packaging is intact, undamaged, and dry, and that sterilization indicators are present on sterilized items, with the appropriate colour change).

– Provide the individual with a clean specimen pot. (The assessor will then pass the sample to the candidate.)

– Put on disposable plastic apron and non-sterile gloves.

– Briefly immerse the reagent strip into the urine for no more than one second.

– Hold the strip at an angle at the container’s edge.

– Wait the specified duration before comparing the strip to the colour chart – verbal description is acceptable.

– Dispose of the equipment appropriately – verbal description is acceptable.

– Use alcohol-based hand rub to cleanse your hands following WHO guidelines – verbal description is acceptable.

– Interpret the potential significance of the findings, offer relevant health information based on the results, and explain the subsequent steps to the individual.

– Accurately record the readings in accordance with the reagent strip guidelines.

SCRIPT ROLEPLAY

Nurse: Hello Catriona, I’m here to collect a urine sample for a urinalysis test. Is now a convenient time for this?

Catriona: Alright.

Nurse: Great, Catriona. For this procedure, you’ll need to use the restroom and collect a urine sample in this container. Can you manage that by yourself?

Catriona: Yes.

Nurse: Perfect. Before you start, please remember to cleanse your meatus by gently washing from front to back after parting your labia with soap and water. Begin urinating a small amount, pause, then hold the specimen container a few centimeters from your urethra. Urinate until the container is about halfway full, and then stop. You can discard the rest. This is how we obtain a midstream urine sample. Is that clear?

Catriona: Yes.

Nurse: Excellent. Here’s your specimen container. Now, I’ll prepare the necessary items for the urinalysis. I have a kidney tray, the Multistix 8SG strips in intact and up-to-date packaging, a tissue paper, and a functioning FOB watch.

Now that I have your midstream urine sample, I’ll take one strip from the container, close it, and open the specimen bottle. I’ll wait for the second hand to reach 12 o’clock for easier timing.

I’ll dip the strip into the specimen and quickly remove it, ensuring no spillage. I’ll place it on the tissue paper and wait for 30 seconds to check for glucose. I’ll also remove my gloves, as I’ve touched the specimen bottle.

After 30 seconds, I found a glucose reading of 2+. At 40 seconds, ketones are negative, and the specific gravity is 1.005. I’ll wait until 60 seconds, during which I’ll note the ketone and specific gravity values.

At 60 seconds, I’ll check for negative results on blood, protein, nitrite, and pH. Then, I’ll wait another minute to check for leucocytes. After 60 seconds, I can confirm that blood, protein, nitrite, and pH are all negative, and the pH level is 5.0. Two minutes have passed, and the leucocytes are also negative.

Hello, Catriona, I have obtained some values from your urinalysis. It indicates a slightly elevated glucose level in your urine. I’ll inform the doctor, who will review the results and provide further guidance. In the meantime, please remember to drink 2-2.5 liters of water daily to stay hydrated and practice regular handwashing.

Catriona: Understood.

Nurse: Great, Catriona. I’ll be nearby for a little while longer. If you need any assistance, simply press the call button, and I’ll come right over.

Assessor, I have completed the midstream urinalysis for Ms. Catriona. Now, I’ll dispose of all waste materials, document the procedures in accordance with NMC guidelines and policies, and clean the tray to prepare it for the next use.

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