Urinalysis Review
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| Random urine | Can be collected any time of the day used for routine analysis.
Specimen collected using a clean container.
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| Timed urine | Patient is given a specific time for collection. May be done with blood test.
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| First morning urine | Most concentrated sample. Best for pregnancy test. Collected in clean container. Preferred sample for microscopic urine. Sample contains more
dissolved substances.
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| Catheterized Urine | Sterile collection. Aspirated from catheter using syringe. Less commonly performed due to risk of infection.
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| Midstream urine | Sterile procedure used for C & S (culture and sensitivity).
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| 24-hour urine | Clean container. Used for total fluid excretion measurements.
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| How many hours after urine collection should the sample be refrigerated based on OSMT requirements? | 2 hour.s
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| 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
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| Which specimen is more concentrated? | First morning urine. It contains more dissolved substances.
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| Name the 10 tests for urinalysis. | • Glucose
• Bilirubin
• Ketones
• Blood
• pH
• Protein
• Urobilinogen
• Nitrites
• Leukocyte Esterase
• Specific gravity
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| Proteinuria | The presence of protein in the urine.
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| Hematuria | The presence of intact red blood cells in the urine.
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| Hemoglobinuria | The presence of free hemoglobin in the urine.
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| Anuria | The failure of the kidneys to produce urine.
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| Glycosuria | The presence of glucose in the urine.
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| Nocturia | Excessive urination during the night.
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| Ketonuria | The presence of excessive amount of ketone bodies in the urine.
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| Bilirubinruia | The presence of Bilirubin in the urine.
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| Oliguria | The production of abnormally small amounts of urine.
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| Polyuria | Excessive production or passing of urine. (greater than 2.5 of 3L over 24 hours)
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| Dysuria | Pain or discomfort when urinating.
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| What is the normal range for specific gravity for urine? | 1.005 – 1.035
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| What is the normal range of pH for urine? | 4.5 – 8.0 pH
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| What is the average pH of urine? | 6.0 pH
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| What does a higher pH reading indicate? | a higher range indicates the sample is Alkaline
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| What does a lower pH reading indicate? | a lower range indicates the sample is Acidic
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| 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.
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| Name 4 non-pathological reasons for abnormal color. | • Diet
• Vitamins
• Drugs
• Excessive consumption of water will cause Pale urine
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| Name 4 pathological reasons for abnormal color. | • Urates or uric acid
• Haemoglobin
• Red blood cells (R.B.C’s)
• Porphyrins
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| What is the confirmation test for Glucose? | Clinitest
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| What is the confirmation test for Protein? | Sulfosalicylic acid test (SSA)
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| What is the confirmation test for Bilirubin | Ictotest
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| What is the confirmation test for Ketones | Acetest
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| 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
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| 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
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| 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)
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| 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
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| What kind of infection can be associated with a catherized collection? | Nosocomial infections (hospital acquired infection)
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| What is unusual about the way bacteria reacts? | Bacteria multiples 2 fold every 20 minutes whilst the specimen is at room temperature
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| 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.
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| When is a microscopic examination required? | After performing a routine dipstick if there is a positive reading.
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| 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
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| What is QC? | Quality control
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| What does QC do? | Ensures that dipsticks are accurate and working correctly
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| How many controls are run? What ones? | • 2 controls are run
• 1 normal control and 1 abnormal control
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| When would you run controls? | • 1 time per shift
• 1 time per day
• when ever an abnormal result is received
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