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Urinalysis Review
| Question | Answer |
|---|---|
| Random urine | Can be collected any time of the day used for routine analysis. Specimen collected using a clean container. |
| Timed urine | Patient is given a specific time for collection. May be done with blood test. |
| First morning urine | Most concentrated sample. Best for pregnancy test. Collected in clean container. Preferred sample for microscopic urine. Sample contains more dissolved substances. |
| Catheterized Urine | Sterile collection. Aspirated from catheter using syringe. Less commonly performed due to risk of infection. |
| Midstream urine | Sterile procedure used for C & S (culture and sensitivity). |
| 24-hour urine | Clean container. Used for total fluid excretion measurements. |
| How many hours after urine collection should the sample be refrigerated based on OSMT requirements? | 2 hour.s |
| What 7 factors influence volume? | • Fluid intake • Emotions • Temperature (heat) • Blood pressure • Hormones (ADH) • Diuretic drinks i.e. coffee and medications i.e. furosemide • Insulin |
| Which specimen is more concentrated? | First morning urine. It contains more dissolved substances. |
| Name the 10 tests for urinalysis. | • Glucose • Bilirubin • Ketones • Blood • pH • Protein • Urobilinogen • Nitrites • Leukocyte Esterase • Specific gravity |
| Proteinuria | The presence of protein in the urine. |
| Hematuria | The presence of intact red blood cells in the urine. |
| Hemoglobinuria | The presence of free hemoglobin in the urine. |
| Anuria | The failure of the kidneys to produce urine. |
| Glycosuria | The presence of glucose in the urine. |
| Nocturia | Excessive urination during the night. |
| Ketonuria | The presence of excessive amount of ketone bodies in the urine. |
| Bilirubinruia | The presence of Bilirubin in the urine. |
| Oliguria | The production of abnormally small amounts of urine. |
| Polyuria | Excessive production or passing of urine. (greater than 2.5 of 3L over 24 hours) |
| Dysuria | Pain or discomfort when urinating. |
| What is the normal range for specific gravity for urine? | 1.005 – 1.035 |
| What is the normal range of pH for urine? | 4.5 – 8.0 pH |
| What is the average pH of urine? | 6.0 pH |
| What does a higher pH reading indicate? | a higher range indicates the sample is Alkaline |
| What does a lower pH reading indicate? | a lower range indicates the sample is Acidic |
| Why would urine appear cloudy? | • Urine may be cloudy if left out for long periods of time without refrigeration. • If urine is “fresh” and cloudy may indicate the presence of Bacteria, Pus, Mucous,Sperm or Crystals in the sample. |
| Name 4 non-pathological reasons for abnormal color. | • Diet • Vitamins • Drugs • Excessive consumption of water will cause Pale urine |
| Name 4 pathological reasons for abnormal color. | • Urates or uric acid • Haemoglobin • Red blood cells (R.B.C’s) • Porphyrins |
| What is the confirmation test for Glucose? | Clinitest |
| What is the confirmation test for Protein? | Sulfosalicylic acid test (SSA) |
| What is the confirmation test for Bilirubin | Ictotest |
| What is the confirmation test for Ketones | Acetest |
| What is the procedure for C & S for midstream urine collection | • Cleanse the site x 3 • Void small amount into toilet • Collect middle portion of urine • Void last amount into toilet • Do not touch inside of container |
| Blood is found in urine what does this indicate? | Hematuria may indicate one of the following benign conditions: • Kidney trauma • Urinary tract stones • Upper UTI (Kidney infection) • Lower UTI (Cystitis – bladder infection) • Menstruation |
| Give the special instructions for a 24-hour urine collection to a patient | • Use clean container. • Discard 1st morning specimen, then collect urine for 24 hours including 1st morning specimen on 2nd day. • Patient to fill out label on container (Name, D.O.B., Height, weight) |
| What substances if found in urine must be reported? | • Sperm in any female under the age of 14 • Sperm in any female residing in a nursing home • Sperm in a male patient’s urine |
| What kind of infection can be associated with a catherized collection? | Nosocomial infections (hospital acquired infection) |
| What is unusual about the way bacteria reacts? | Bacteria multiples 2 fold every 20 minutes whilst the specimen is at room temperature |
| What is R & M? | R & M is an abbreviation for Routine and Microscopic – routine chemical and microscopic analysis of urine usually using a dipstick method. |
| When is a microscopic examination required? | After performing a routine dipstick if there is a positive reading. |
| What are 4 important things about dipstick. | • Check the expiry date and lot numbers • Protect the stick from light • Protect the stick from moisture and the lid closed • Check for discoloration of the dip stick color patches |
| What is QC? | Quality control |
| What does QC do? | Ensures that dipsticks are accurate and working correctly |
| How many controls are run? What ones? | • 2 controls are run • 1 normal control and 1 abnormal control |
| When would you run controls? | • 1 time per shift • 1 time per day • when ever an abnormal result is received |
Created by:
stephen.kahler
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