What should a nurse do when collecting a 24-hour urine specimen?

When collecting a 24-hour urine specimen, the appropriate procedure involves asking the client to first void, discarding that initial sample, and then noting the start time for the collection period. This initial voiding is discarded to ensure that only urine produced after the start of the collection is included in the final specimen. This method ensures accuracy in measuring kidney function or other specific metabolic processes over the designated 24-hour period.

Starting the timing after discarding the initial urine is essential because it eliminates any urine that may have been produced before the collection officially begins, thereby providing a true representation of the patient's renal output during the specified time frame. Proper adherence to this protocol is vital for the validity of the test results, which may be used for diagnosing conditions such as kidney disease, electrolyte imbalances, or other metabolic disorders.

Other options fail to follow correct procedures. For instance, collecting the first void and starting the timing without discarding introduces urine that may not reflect the true 24-hour output, while limiting fluid intake can lead to concentrated urine, skewing the results. Collecting all voided urine without an appropriate starting point or guidelines also compromises the specimen’s integrity.