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Mod 2 Ch 46

Ch. 46 Urinalysis

24-hour urine specimen -determines filtration rate of kidneys -first thing in the morning is the start time -first void is discarded -note the time -do not void directly into container
clean-catch mid-stream -detects UTIs -must use sterile container -clean urethra area well (3 cloths) -label container before test -start to urinate in toilet, then stop -urinate into the container
3 reasons for urinalysis 1. routine evaluation 2. diagnostic purposes 3. monitor course of treatment
MA's role -collect -store -process for testing -labeling
random sample -most commonly used collection process -can be collected at any time during the day -a non-sterile container can be used
morning specimen - first void -most concentrated sample -bring to office within 30 min
when to refrigerate urine any specimen not tested within 30 minutes
two-hour postprandial -used to screen and look at renal thresh hold -collected 2 hours after a meal
Catheterization specimens 1. foley - used for collecting over long periods of time 2. straight - used for one-time specimen collections
physical characteristics 1. appearance 2. color 3. odor 4. quantity
appearance urine can be clear, cloudy, or turbid (doesn't allow light to pass thru)
color -normal is straw or pale yellow. -can range from clear (on diuretics or too hydrated), bright yellow (high vit B), orange (meds for bladder spasms), red/brown (uti, menses), brown/black (serious illness), and blue/green (meds)
odor -any abnormal odor should be noted -odors include: ammonia (urine breakdown), fruity (fat metabolism or glucose), and foul (infection)
quantity (volume) -measured for timed specimens -24-hour amount = 700-2000 mL with average of 1500mL
chemical characteristics -specific gravity -pH -protein -glucose hematuria (blood) -ketones -bilirubin -urobilinogen -nitrates -leukocytes
specific gravity -estimates the concentration of urine
pH -normal is 4.6 - 7.9, usually around 6.0
protein, glucose, hematuria, keytones, bilirubin, and nitrates -not normally found in urine -presence indicates infection or problem
urobilinogen -usually found in small quantities -indicated RBC destruction
nitrates -increase indicates bacteria in urine - UTI
leukocytes (WBCs) -very few found -increase indicates UTI
refractometer usually used in Urology office
testing urine w reagent strips -after dipping strip, hold strip on its side so each cell doesn't drip into the next one and contaminate results -compare strip to colors on container which indicate results
reagent tablet testing -verifies presence of glucose -liquid boils, so do not hold tube, use test-tube rack
microscopic examination -not CLIA-waived, must be performed by the Provider
preparing urine for microscopic exam -pour fresh urine into tube -centrifuge -pour of supernatant -sediment remains -stain remains to better contrast the formed elements present
supernatant lighter liquid on top of urine sample after centrifuging
sediment solid material left on bottom of tube after centrifuging
urine pregnancy test -perform hand hygiene -gather supplies -label test -label / perform control -complete and time test according to pkg directions -read and record results -document qc in log -dispose of supplies -wash hands
drug analysis -bathroom prep is most important step -follow chain of custody (important b/c the testing is accurate and there is no tampering with specimen) -prepare pt.
quality control necessary for accurate results
Created by: vanstellee