Ch. 46 Urinalysis
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| 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
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| 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
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| 3 reasons for urinalysis | 1. routine evaluation
2. diagnostic purposes
3. monitor course of treatment
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| MA's role | -collect
-store
-process for testing
-labeling
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| random sample | -most commonly used collection process
-can be collected at any time during the day
-a non-sterile container can be used
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| morning specimen - first void | -most concentrated sample
-bring to office within 30 min
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| when to refrigerate urine | any specimen not tested within 30 minutes
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| two-hour postprandial | -used to screen and look at renal thresh hold
-collected 2 hours after a meal
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| Catheterization specimens | 1. foley - used for collecting over long periods of time
2. straight - used for one-time specimen collections
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| physical characteristics | 1. appearance
2. color
3. odor
4. quantity
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| appearance | urine can be clear, cloudy, or turbid (doesn't allow light to pass thru)
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| 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)
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| odor | -any abnormal odor should be noted
-odors include: ammonia (urine breakdown), fruity (fat metabolism or glucose), and foul (infection)
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| quantity (volume) | -measured for timed specimens
-24-hour amount = 700-2000 mL with average of 1500mL
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| chemical characteristics | -specific gravity
-pH
-protein
-glucose
hematuria (blood)
-ketones
-bilirubin
-urobilinogen
-nitrates
-leukocytes
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| specific gravity | -estimates the concentration of urine
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| pH | -normal is 4.6 - 7.9, usually around 6.0
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| protein, glucose, hematuria, keytones, bilirubin, and nitrates | -not normally found in urine
-presence indicates infection or problem
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| urobilinogen | -usually found in small quantities
-indicated RBC destruction
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| nitrates | -increase indicates bacteria in urine - UTI
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| leukocytes (WBCs) | -very few found
-increase indicates UTI
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| refractometer | usually used in Urology office
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| 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
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| reagent tablet testing | -verifies presence of glucose
-liquid boils, so do not hold tube, use test-tube rack
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| microscopic examination | -not CLIA-waived, must be performed by the Provider
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| 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
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| supernatant | lighter liquid on top of urine sample after centrifuging
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| sediment | solid material left on bottom of tube after centrifuging
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| 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
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| 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.
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| quality control | necessary for accurate results
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