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Urinalysis Review

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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