PATIENT PREPARATION PATIENT PREPARATION FOR LAB TESTS URINE SPECIMENS

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1 PATIENT PREPARATION FOR LAB TESTS URINE SPECIMENS 24-HOUR URINE SPECIMENS Please follow these instructions in collecting your 24-hour urine specimen. You will find it more convenient to void (urinate) into the smaller container provided and transfer the urine into the larger collection container. Do not add anything but urine to the container and do not pour out any liquid or powder that may already be in the collection container. These substances may cause burns if touched. The collection container should be kept refrigerated throughout the collection period. 1. Upon arising in the morning, urinate into the toilet, emptying you bladder completely. Do not collect this sample. Note the exact time and print it on the container label. 2. Collect all urine voided for 24 hours after this time in the container provided. All urine passed during the 24-hour time period (day and night) must be saved. Urine passed during bowel movements must also be collected. Be careful not to contaminate urine specimen with feces. 3. Refrigerate the collected urine between all voidings or keep in a cool place. 4. At exactly the same time the following morning, void completely again (first time after awakening) and add this sample to the collection container. This completes your 24-hour collection. 5. Be sure to label specimen with patient s name, date and time the collection began and ended. 6. Take the 24-hour specimen to the Outpatient service area as soon as possible, maintaining the cool temperature in transit by placing the specimen in a portable cooler or insulated bag. CONTAINERS: Sterile containers and 24 hr urine containers may be picked up at Outpatient service between the hours of 6am to 6pm. After hours, please contact laboratory for container. 24-HR CREATININE CLEARANCE This test requires a 24-hour urine collection and a blood sample drawn during the collection period. We will, however accept blood draw either at the beginning or end of the urine collection. Please inform the staff when you return your 24 hour urine collection if you have not had your blood drawn by our lab prior to or during the collection. You will also be asked to provide your current height and weight. Follow directions for 24-hour urine specimen collection. Please label the container with patient s name, date and time the collection began and ended. 1

2 CATECHOLAMINE 24-HOUR URINE Diet, exercise, and drugs may affect catecholamine levels. Precautions need to be taken to assure that the sample reflects a true metabolic condition and not an interference or aberration. For this reason, you should talk to your doctor about your diet and any medications you are taking. Foods such as coffee (including decaf), tea, chocolate, vanilla, bananas, oranges and other citrus fruits should be avoided for several days prior to the test and during the collection. There are also many medications that can potentially affect test results. Talk to your doctor about prescription and over-the-counter drugs and supplements you are taking. Emotional and physical stress and vigorous exercise should be minimized prior and during collection. Follow directions for 24-hour urine specimen collection. The container will have a preservative added. Please do not discard and do not touch. The preservative may cause burns. Flush the area with large amounts of water if you come in contact with the preservative. Please label the container with patient s name, date and time the collection began and ended. TOTAL PROTEIN 24-HOUR URINE No special diet is required for this test. Follow instructions for 24-hour urine collection. Please label the container with patient s name, date and time the collection began and ended. 5-HIAA (24-HOUR URINE COLLECTION) Patient preparation is important for accurate 5-HIAA test results. Foods such as avocados, bananas, pineapples, plums, walnuts, tomatoes, kiwi fruit, and eggplant can interfere with 5-HIAA measurement and should be avoided for 3 days prior to and during urine collection. There are also a variety of medications that can affect the 5-HIAA test, but you should talk to your doctor before decreasing or discontinuing any medications. Follow instructions for 24-hour urine collection. Please label the container with patient s name, date and time the collection began and ended. HEAVY METAL ( 24-HOUR URINE COLLECTION) Avoid contact with metal during the urine collection. The specimen should be kept at room temperature. Avoid seafood and red wine for 72 hours prior to and during to collection. Follow instructions for 24-hour urine collection. Please label the container with patient s name, date and time the collection began and ended. METANEPHRINES (24-HOUR URINE COLLECTION) It is important that the sample be kept cool (refrigerated or on ice) during the collection period. Since diet, exercise, and drugs may affect metanephrine levels, precautions need to be taken to assure that the sample reflects a true metabolic condition and not an interference or aberration. For this reason you should talk to your doctor about your diet and any medications you are taking. Foods such as coffee (including decaf), tea, chocolate, vanilla, bananas, oranges and other citrus fruits should be avoided for several days prior to the test and during 24-hr urine collection. There are many medications that can affect test results. Talk to your doctor about the prescriptions and over the counter 2

3 drugs and supplements that you are taking. Whenever possible, those that are known to interfere should be discontinued prior to and during collection, but always check with you doctor. Emotional and physical stress and vigorous exercise should be minimized prior and during collection. Follow directions for 24-hour urine specimen collection. The container will have a preservative added. Please do not discard and do not touch. The preservative may cause burns. Flush the area with large amounts of water if you come in contact with the preservative. Please label the container with patient s name, date and time the collection began and ended. PORPHYRINS/PORPHOBILINOGEN 24-HOUR URINE Collect 24-hour urine as described above. This specimen must be refrigerated and protected from light. Return to Outpatient services as soon possible. To protect from light, wrap container completely with aluminum foil if not in amber or dark specimen container. Please label the container with patient s name, date and time the collection began and ended. URINE FOR URINALYSIS AND/OR CULTURE Female: The patient should be seated on the toilet or bedpan with legs separated. Separate labia minor (inner folds), cleanse opening of urethra three times with cleansing pads. Allow the initial stream of urine to pass, and then collect urine into a sterile container. Male: cleanse glans three times with cleaning pads. Allow the initial stream of urine to pass, and then collect urine into a sterile container. The specimen should be returned as soon as possible. If there is a delay, the specimen should be refrigerated. Please label the specimen with patient s name, date and time of collection. URINE CYTOLOGY First morning specimen. Return to Outpatient services within 30 minutes of collection. Please label the specimen with patient s name, date and time of collection. STOOL SAMPLES FOR TESTING C. DIFFICILE (CDT) A fresh stool sample is collected into a sterile container. The stool sample should not be contaminated with urine or water. Once it has been collected, the stool specimen should be taken to the laboratory within about one hour. If unable to return to lab in one hour the specimen should be refrigerated and taken to Outpatient services as soon as possible. The container should be labeled with the patient s name and the date and time of the stool collection. STOOL FOR OCCULT BLOOD Diet and drugs may affect results of occult blood testing. Please talk to your physician before making any changes in diet or medications prescribed for you. 3

4 For three days before and during stool collection eat a well balanced diet including fiber such as bran cereals, fruits and vegetables. Avoid red meats, including beef, lamb, and liver. There are also some common over-the-counter drugs that may affect results of the testing. For seven days before and during the stool collection period, avoid non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, or aspirin. Aspirin may be taken if not in excess of one adult aspirin or 325mg per day. Acetaminophen (Tylenol) may be taken as needed. For three days before and during the stool collection period, avoid vitamin C in excess of 250mg/day from supplements, citrus fruits, and juices. Iron supplements may be taken if they do not contain more than 250 mg of vitamin C. Your doctor or laboratory will give you one or more test cards. You will collect a separate sample from three different stools, usually on consecutive days. Each stool specimen should be collected into a clean container and should not be contaminated with urine or water. The card should be labeled with your name, date and time of collection. Then with an applicator stick, you apply a thin smear of stool onto each filter paper/square/window contained on the card. Allow the filter paper to dry. Once it is dry, it is stable. Usually you will collect all of the consecutive samples, then return them to Outpatient services. STOOL FOR FECAL FATS, FECAL FIBER AND/OR WHITE BLOOD CELLS (WBC) A fresh stool sample is collected in a sterile container. The specimen should be returned as soon as possible. If unable to do so, refrigerate the specimen and return as soon as possible to Outpatient services. Please label specimen container with patient s name, date and time of collection. STOOL FOR CULTURE A fresh stool sample is collected into a sterile container. The stool sample should not be contaminated with urine or water. The specimen should be returned to Outpatient services as soon as possible. If unable to do so, refrigerate the specimen and return as soon as possible. Please label the specimen container with patient s name, date and time of collection. OTHER SPECIMENS SEMEN ANALYSIS 1. Refrain from sexual intercourse or masturbation for between 2 and7 days. 2. Produce the sample by masturbation without artificial lubricants. Do not use a condom, as condoms contain spermicidal agents. 3. Collect the sample into the clean, wide mouth container supplied. It is important that the whole ejaculate is collected. If not, the specimen should be labeled as incomplete. 4. Within 1 hour of collection, bring the sample to Outpatient services or to the laboratory. Keep the specimen warm in a pocket near your body. 4

5 5. Label the specimen with name, date, and time of the collection. 6. Complete the patient questionnaire (found in OP registration or Lab front desk) and return to Outpatient services or laboratory with the specimen. 7. Samples may also be produced in a room at the laboratory. SPUTUM FOR CULTURE AND ACID FAST MYCOBACTERIUM (AFB) Patient should rinse mouth and gargle with water immediately prior to collection. Collect specimen from deep cough into a sterile container. Patient should avoid any contamination with saliva. Return specimen as soon as possible. If there is a delay, specimen should be refrigerated. Please label the specimen container with patient s name, date and time. PATIENT PREPARTION FOR BLOOD TESTS LIPID PROFILE Patient should be on a stable diet ideally for 2-3 weeks prior to testing. Patient should fast for 12 to 14 hours before blood collection. Fasting should be no food or drink except for water. CORTISOL Typically, blood will be drawn from a vein in the arm, but sometimes urine may be tested. Cortisol blood tests may be drawn at about 8 am, when cortisol should be at its peak, and again at about 4pm, when the level should have dropped. Sometimes a resting sample will be obtained late in the evening. Sometimes urine is tested for cortisol. This usually requires a 24-hour collection, but may be done on a single sample of urine collected in the morning. If 24-hr collection is ordered, a special preservative is needed. Please contact laboratory for proper container. C-PEPTIDE Patient should be fasting (no food or drink, except for water) for hours before blood is drawn. VITAMIN B12 AND FOLATE A fasting specimen (no food or drink, except for water) for hours before blood is drawn is preferred. However, your doctor may request that you have your blood drawn when you are not fasting. DIGOXIN LEVEL Blood should be drawn 6-8 hours after the last dose. GLUCOSE TOLERANCE TESTS 50 GRAM 1 HOUR GLUCOSE TOLERANCE TEST (GESTATIONAL DIABETES SCREEN) 5

6 No special patient preparation is required. This test is done without regard to the time of day or time of last meal. You will be given a special drink and your blood will be drawn one hour after you finish the drink. 100 GRAM 3 HOUR GLUCOSE TOLERANCE TEST (GESTATIONAL DIABETES) Patient preparation: This test should be performed in the morning after an overnight fast of at least 8 hours but not more than 14 hours and after at least 3 days of unrestricted diet and activity. A blood specimen will be drawn and tested. You will then be given a special drink. Your blood will be drawn once each hour after you finish the drink for three hours. GLUCOSE TOLERANCE TEST (NON-PREGNANT) Patient should be fasting for 12 to 14 hours (no food or drink, except for water).. A blood specimen will be drawn and tested. You will then be given a special drink. Your blood will be drawn once each hour after you finish the drink. The number of hours may vary from 2 to 6. Your doctor will decide how many hours you will be tested. GASTRIN Patient must be fasting for 12 to 14 hours (no food or drink, except for water). LACTOSE TOLERANCE TEST Patient should fast for 8 hours (no food or drink, except for water) before testing. No smoking or gum chewing allowed during test. Patient is encouraged to drink 1-2 glasses of water during test. Patient should remain seated or lying done during test. For any tests not listed or other questions, please contact laboratory.. 6

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