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z_NUR112: Exam 4 > Ch 46: Urination - Labs > Flashcards

Ch 46: Urination - Labs Flashcards

1
Q

When assessing urine, what do we observe?

A
  • Amount
    • Output
    • Intake v. Output analysis
  • Characteristics
    • Color
    • Clarity
    • Odor
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2
Q

Explain the normal and abnormal characteristics of urine:

Color

A
  • Normal
    • Ranges from light yellow to dark amber yellow, depending on how concentrated is the urine
  • Abnormal
    • Hematuria – Pink or red urine occurs with bleeding in the urinary tract
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3
Q

Explain the normal and abnormal characteristics of urine:

Clarity

A
  • Normal
    • Clear
  • Abnormal
    • Cloudy – suggests infection or other substance in the urine (e.g., sperm, crystals, or mucus)
    • Blood clots – may be present in people who have had recent bladder or kidney surgery
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4
Q

Explain the normal and abnormal characteristics of urine:

Odor

A
  • Normal
    • Mild aromatic
  • Abnormal
    • Sweet, fruity – elevated urine glucose (e.g., diabetes)
    • Strong, unpleasant – suggests infection
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5
Q

Explain the normal and abnormal characteristics of urine:

Amount

A
  • Normal
    • Variable in sample (>30mL ok, normal output is about 60 mL/hr)
  • Abnormal
  • Urine output of less than 30 mL/hr
    • may indicate decreased kidney perfusion
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6
Q

What seven components are reported in a Urinalysis?

A
  1. Specific gravity
  2. pH
  3. Protein
  4. Glucose
  5. Ketones
  6. Microscopic analysis
  7. Nitrate/leukocyte esterase
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7
Q

What is the normal urinalysis value for:

Specific Gravity

A

1.005 - 1.030

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8
Q

What is the normal urinalysis value for:

pH

A

Average of 6

(slightly acidotic)

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9
Q

What is the normal urinalysis value for:

Protein

A

Negative

(abscent)

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10
Q

What is the normal urinalysis value for:

Glucose

A

Negative

(abscent or very low)

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11
Q

What is the normal urinalysis value for:

Ketones

A

Negative

(abscent)

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12
Q

What is the normal urinalysis value for:

Microscopic analysis

A

Negative for WBC, casts, plugs, crystals or pathogens

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13
Q

What is the normal urinalysis value for:

Nitrate/leukosyte esterase

A

Negative

(abscent)

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14
Q

Urinalysis

Give the significance of abnormal values for:

Specific Gravity

A
  • Increased – dehydration
  • Decreased – high fluid intake and diuretic therapy
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15
Q

Urinalysis

Give the significance of abnormal values for:

pH

A
  • Decreased – metabolic acidosis
  • Increased – metabolic alkalosis
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16
Q

Urinalysis

Give the significance of abnormal values for:

Protein

A

Increases usually result from kidney diseases that affect the glomeruli; may also occur with pregnancy, vigorous exercise

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17
Q

Urinalysis

Give the significance of abnormal values for:

Glucose

A

Increased – diabetes, kidney injury

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18
Q

Urinalysis

Give the significance of abnormal values for:

Ketones

A

Increased – diabetes (diabetic ketoacidosis), long-term starvation, severe or prolonged vomiting

19
Q

Urinalysis

Give the significance of abnormal values for:

Microscopic analysis

A

Presence of crystals suggests renal calculi; presence of bacteria, yeast, or parasites indicate infection

20
Q

Urinalysis

Give the significance of abnormal values for:

Nitrate/leukocyte esterase

A

Increase – bacterial infection

21
Q

What are the six urinary diagnostic tests?

A
  1. Urinalysis
  2. Ultrasound
  3. KUB study
  4. Intravenous Pyelography
  5. Computed Tomography
  6. Cystoscopy
22
Q

What is an ultrasound?

What is it used for regarding urine?

A
  • Definition
    • A painless, noninvasive procedure that uses high-frequency sound waves to view interior structures of the body.
  • Use
    • To view and assess the size, shape and location of kidneys and bladder
    • Check for residual amount after complete void
23
Q

What is a KUB Study?

A
  • The Kidney, Ureter, and Bladder (KUB) study is a diagnostic x-ray image that can detect the presence of kidney stones.
24
Q

What else can a KUB Study be used for?

A
  • to assess positioning of indwelling devices such as ureteral stent (an indwelling tube placed in the ureter to treat obstruction).
25
Q

What is an Intravenous Pyelography?

A

an intravenous pyelogram (IVP) x-ray study uses a contrast media to evaluate the size, shape, and position of the entire urinary tract.

26
Q

What is a intravenous pyelography used for?

A
  • to identify kidney stones, tumors, or infection
  • to measure the size of a urinary tract tumor
  • to look for urinary tract damage after injury.
27
Q

What are some contraindications of having the IVP?

A
  • Iodine allergy
  • Kidney disease
28
Q

Why is a pt encouraged to drink fluids after an IVP?

A

To flush the contrast media out of their system

29
Q

What is Computed Tomography (CT Scan) used for?

A
  • to diagnose kidney stones, bladder stones, or blockage of the urinary tract
  • Contrast media may be used during the procedure to help identify blockages, growths, infections, or other diseases.
30
Q

Are there any contraindications for a CT?

A
  • allergy to iodine
31
Q

What is a Cystoscopy?

A

Cystoscopy is an endoscopic exam using a device with a light at the tip (a cystoscope) to view directly the urethra and bladder.

32
Q

What is a Cystoscopy used for?

A
  • It can be used to assess, diagnose, and treat problems of the lower urinary tract.
  • determine the cause of urinary symptoms.
  • evaluation of lower urinary tract obstruction, tissue biopsy, and removal of tissue or small stones (calculi).
33
Q

What are some precautions to keep in mind for a Cystoscopy?

A
  • Cystoscopy requires patient preparation and anesthesia (local, spinal, or general) may be used during the procedure
  • Following the procedure, the patient is closely monitored for bleeding and temporary difficulties with urinating related to anesthesia and swelling from the procedure.
34
Q

What is a BUN test?

A
  • Blood Urea Nitrogen test
  • It is a serum test of kidney function that measures urea, the end product of protein metabolism
35
Q

What is the normal range for a BUN test?

A

10-20 mg/dL

36
Q

What do high levels indicate on a BUN test?

A

>20 =

  • Renal disease
  • dehydration
  • diabetes
  • hypertension
  • medications
37
Q

What do low levels indicate on a BUN test?

A

<10 =

  • Liver disease/damage
  • fluid overload
  • Low protein diet
  • malnutrition
38
Q

A creatinine clearance test may be ordered when…

A

a problem of kidney function is suspected or identified

39
Q

Describe a Creatinine Clearance Test

A
  • The timed urine specimen is to measure the amount of creatinine that clears the kidneys over a 24-hour period.
  • Creatinine clearance measures how well the kidneys remove creatinine from the blood.
  • It provides information about kidney function.
40
Q

What are the steps to a Creatinine Clearance Test?

A
  • It is a 24-hour urine collection
  • The test usually begins with the patient’s first morning void being discarded.
  • All subsequent urine is saved in a cooled container for a full 24-hour period.
  • The first morning void at the end of the 24-hour period is included in the sample.
41
Q

A urine culture and sensitivity test is needed when…

A

infection is suspected.

42
Q

Describe the Culture and Sensitivity Test

A
  • The culture and sensitivity test is for identification of a urinary pathogen (culture) and an appropriate antibiotic (sensitivity).
  • Urine in the bladder is normally sterile; it is free of bacteria or organisms.
  • If the culture is positive for organisms, sensitivity testing is performed to determine the appropriate antibiotic for treatment.
43
Q

Urine samples must come from the _____ and not _____ because it is _____.

A

bladder, a bag, sterile

z_NUR112: Exam 4 (12 decks)

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