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Fundamentals & Clinical Procedures > Ch 16 - Urinalysis > Flashcards

Ch 16 - Urinalysis Flashcards

1
Q

why a first-voided morning specimen is often preferred for urinalysis

A

it is the most concentrated and most accurate sample

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2
Q

what is urea

A

breakdown of proteins

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3
Q

define micturition

A

to urinate

normal act of voiding urine

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4
Q

define nocturnal enuresis

A

inability of pt to control urination at night during sleep

bedwetting

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5
Q

define retention

A

the inability to empty the bladder

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6
Q

where can you find microorganisms in the urethra?

A

normally only in the distal urethra and urinary meatus

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7
Q

what is urine composed of

A

95% water
5% inorganic and organic substances creatinine

inorganic wastes - chloride, sodium, potassium, calcium, magnesium, phosphate, sulfate

organic wastes - urea, uric acid, ammonia,

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8
Q

how much urine does a normal adult excrete

A

about 700 - 2000 mL of urine per day

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9
Q

define anuria

A

failure of kidneys to produce urine

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10
Q

define diuresis

A

secretion and passage of large amounts of urine

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11
Q

define nocturia

A

excessive voluntary urination at night

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12
Q

define nocturnal enuresis

A

involuntary bedwetting while asleep

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13
Q

define oliguria

A

decreased output of urine

below 400 mL output in 24 hours

due to decreased fluid intake, dehydration, profuse perspiration, vomiting, diarrhea, kidney disease

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14
Q

define polyuria

A

increased output of urine

exceeds 2000 mL output in 24 hours

due to excessive intake of fluids or caffeine which is a mild diuretic, certain drugs, DM, diabetes insipidus, renal disease

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15
Q

purpose of first voided or clean catch sample

A

first voided for pregnancy - greatest concentration of substances

clean catch for testing bacteria

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16
Q

purpose of 24 hour urine specimen

A

to test for kidney stone formation and control and prevent new stone formation

used to perform a creatinine clearance test to check kidney function

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17
Q

importance of obtaining a fresh sample for urinalysis

A

urine sample must be examined within an hour

bacteria will convert urea to ammonia, making it from acidic to alkaline - creating a false positive result on protein test

bacteria will multiply resulting in a cloudy specimen and increase in nitrite

bacteria will eat the glucose if there was any

red blood cells or white blood cells will break down

casts decompose after several hours

18
Q

describe the physical examination of urine

A 
color: presence of yellow pigment called urochrome, produced by breakdown of hemoglobin
normal is straw-yellow to dark amber
hemoglobin or blood - red
bile pigments - greenish or yellow brown
fat or pus - milky

appearance: normally clear, but cloudy due to bacteria, pus, blood, fat, yeast, sperm, mucous threads, fecal contaminants
odor: urine smell, ammonia smell if old, foul smell from UTI, sweet from DM

specific gravity: measures the weight of the urine compared with the weight of an equal volume of distilled water. indicates amount of dissolved substance in urine

SG ranges from 1.003 - 1.030 but is usually between 1.010 - 1.025

19
Q

list the types of chemical examination of urine

A

pH: between 4.6 - 8.0 but usually a normal diet results in 6.0; higher pH indicates a bacterial infection

glucose

protein

ketone

bilirubin

urobilinogen

blood

nitrite

leukocytes

20
Q

describe the microscopic examination of urine

A

red blood cells

white blood cells

epithelial cells

casts

misc. structures

21
Q

how to store bottle of reagent strips

A

59-86F
not refrigerator or freezer

discoloration = bad

22
Q

define casts

A

cylindric structures formed in the lumen of the tubules that make the nephron

materials in tubules harden, are flushed out, appear in urine in forms of casts

their presence indicates a disease

hyaline casts

granular casts

fatty casts

waxy casts

cellular casts

rbc casts

wbc casts

epithelial casts

bacterial casts

23
Q

crystals in urine

A

type and number depends on pH of urine. abnormal crystals include leucine, tyrosine, cystine, cholesterol. appear commonly in alkaline urine include amorphous phosphate, triple phosphate, calcium phosphate, ammonium urate crystals

24
Q

glucose in urine

A

glucose: 160 - 180 mg/mL per 100 mL of blood

25
Q

proteins in urine

A

protein: indicates a pathological condition such as renal disease or bacterial infection, glomerular filtration problems but temporary increase in protein can be due to stress or strenuous exercise

26
Q

ketones in urine

A

ketone: normal products of fat metabolism, used by muscle tissue as source of energy. Excess will accumulate in tissues and body fluids known as ketosis

27
Q

bilirubin in urine

A

bilirubin: released from the breakdown of hemoglobin, transported to liver and excreted into bile, leaves as feces. liver conditions such as gallstones, hepatitis, cirrhosis can cause it to leave in urine yellow brown or greenish with yellow foam when shaken

28
Q

urobilinogen in urine

A

urobilinogen: as bilirubin excreted by liver into the intestinal tract, bacteria in intestines will convert it to urobilinogen. 50% is reabsorbed into the body but most is excreted as feces. conditions such as excessive hemolysis, infectious hepatitis, cirrhosis, CHF, infectious mononucleosis can increase urobilinogen in urine

29
Q

epithelial cells in urine

A

epithelial cells: squamous epithelial cells - small amounts are normal and renal epithelial cells are from deeper layers so its presence in urine is abnormal

30
Q

white blood cells in urine

A

white blood cells: granular, nucleus, round. 1.5 bigger than rbc, 0-8 per HPF is normal. if more may indicate inflammation in genitourinary tract

31
Q

red blood cells in urine

A

red blood cells: appear colorless, round, biconcave disks are highly refractile. 0-5 per high power field is normal. if more than may indicate bleeding in urinary tract. rbc cannot be seen if they are hemolyzed - lysed from swelling

32
Q

mucous threads in urine

A

normally present in small amounts in urine

long wavy threadlike structures with pointy ends

33
Q

bacteria in urine

A

bacteria should not be in urinary tract

presence of more than a few bacteria indicates contamination of specimen during collection or a UTI

34
Q

yeast cells in urine

A

smooth refractile bodies with oval shape

yeast cells in female patient urine indicates a vaginal contamination of candida albicans

may also be present in diabetic mellitus patients

35
Q

parasites in patients

A

a contaminant from feces or vaginal material

trichomonas vaginalis is a parasite that causes inflammation in vagina

36
Q

spermatozoa in urine

A

is normal after intercourse

37
Q

purpose of rapid urine cultures

A

quick and efficient, can be done in medical office

assist in UTI diagnosis and effectiveness of antibiotic therapy for UTI

38
Q

function of urine pregnancy tests

A

early diagnosis of pregnancy

checks for presence of a hormone called human chorionic gonadotropin for positive reaction using urine and immunoassay reagent strips

39
Q

human chorionic gonadotropin

A

HCG is produced by the developing fertilized egg and small amounts are secreted in urine and blood

highest level in plasma when tested during first trimester

40
Q

serum pregnancy test

A

radioimmunoassay for HCG in serum of blood

can detect earlier and greater accuracy than urine

diagnose ectopic pregnancy and other abnormalities of embryonic development and gestational diabetes

Fundamentals & Clinical Procedures (12 decks)

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