chp 42 Flashcards
t/f: urine is considered sterile
true
t/f: lower respiratory system is not considered sterile
false
t/f: upper respiratory system is considered sterile
false
what is the time period for fasting
generally 8-12 hours
what should a urine specimen container be labeled with
- pt name
- date & time of collection
- test to be done on specimen
when should urine testing ideally be done
1 hour within collection
what should be done if urine testing can’t be tested within the hour
refrigerate sample
what temperature should urine be before testing
room temperature
what urine test allows for the greatest concentration of urine
morning urine test
what concentrates does timed urine test measure (chemicals)
creatinine, urine urea nitrogen, glucose, sodium, potassium, other analytes affected by daily cycles
how long is timed urine test collected for
8-24 hours
when does timed urine test befing
after first morning void which is not counted
what sometimes needs to be done to timed urine collection because of time
refrigeration or add preservatives
what shows up in substance abuse urine test
all drugs (including OTC) taken in last 30 days
what is checked during a substance abuse urine test while the pt is watching
temperature
what are the physical components of urinalysis
color, clarity, odor, volume, specific gravity
what terms are used to describe color of urine
yellow, straw, dark straw, light straw, light yellow, dark yellow, red, brown, orange, green, blue
what terms are used to describe the clarity of urine
clear, slightly hazy, hazy, cloudy, turbid
what is the average volume of urine given in a sample
20 mL
what does a strong ammonia smell to urine indicate
UTI
what does a mousy/musty smell to urine indicate
phenylketonuria
what does a fruity/acetone smell to urine indicate
diabetes
t/f: certain foods like garlic can produce urine odor
true
what may be used to measure specific gravity of urine
urinometer/refractometer/chemical reagent strips
when measuring specific gravity what is used to compare
distilled water
average specific gravity of urine
1.005-1.03
more diluted the urine, the specific gravity will be ____
lower
what are tested in chemical urinalysis
pH, protein, ketone, bilirubin, urobilinogen, blood, nitrite, leukocyte esterase, glucose
avg pH of urine
5-7
what is used to confirm protein in urine
sulfosalicylic acid test (SSA)
what does protein in urine indicate
kidney disease/failure, UTI, blood
if ketone is found in urine, what does it mean
fat broken down and metabolized in digestive
what does ketones in urine indicate
diabetes, diet high in fat, starvation, wasting away of body
what is used to confirm ketones in urine
ace test
define BILIRUBIN
yellow-orange pigment from liver’s degradation of hemoglobin
why might bilirubin in urine go undetected
it breaks down in light
what confirms bilirubin in urine
ictotest
what does bilirubin in urine indicate
liver damage/disease
what does orange to green urine w/green foam when shaken indicate
hepatits
what does too high or too low amounts of urobilinogen indicate
liver/gallbladder disfunction & spleen and heart problems
define HEMATURIA
RBCs/hemoglobin/myoglobin in urine
what is done to confirm hematuria
microscope evaluation
what does nitrites in urine indicate
microorganisms/bacteria
define ESTERASE
enzyme released by WBC when many cells present in fluid
how is leukocyte esterase presence in urine confirmed
microscope
what does glucose in urine mean
renal threshold exceeded for various reasons
normal values for WBCs in urine for men & women
men: 0-10/hpf
women: 10-20/hpf
normal values for RBCs in urine for men and women
male: 0
female: 5-10/hpf (unless menstruating)
normal values for epithelial cells
few to moderate
are epithelial cells generally seen in urine from men
not really
normal value for bacteria in urine
none to slight
normal value for mucus in urine
slight
normal value for spermatozoa in urine
none
what does spermatozoa in urine in men indicate
disease
should sperm in urine from women be reported
no
normal value for trichomonas in urine
none
what do trichomonas in urine indicate and in what population is it more common
infection; women
normal value for yeast in urine
none
normal value for crystals in urine
none/some
why may some crystals in urine be considered normal/healthy
some are nonpathological and can be result of diet
crystals of these indicate disease
cholesterol, tyrosine, cystine, leukocine, sulfa
normal value for casts in urine
none or some
why may some casts in urine be considered normal/healthy
can just randomly show up otherwise show disease
what does occult blood indicate
colon cancer, bleeding in GI, hemorrhoids, rectal polyps, or ulcerative colitis
guaiac regent turns what color when in the presence of occult blood
blue
generally how many samples are needed in an occult blood test
at least 3
7 days before an occult blood test, the pt should avoid
aspirin, iron supplements, and large doses of vitamin C
2 days before an occult blood test, the pt should avoid
red & processed meats, turnips, broccoli, cauliflower, and melon
2 days before an occult blood test, the pt should
eat a diet high in fiber
how should occult blood slides be stored
at room temp away from heat, sun, and fluorescent lights
purpose of sputum infections
diagnose cancer, viral/bacterial/fungal infections, and TB
list the pt directions for performing a sputum infection
- do it first thing in the morning
- rinse mouth w/water and expel
- uncap sterile container
- cough deeply from deep down and into cup
- recap the container and record date & time
how is a pinworm test performed
office tape to tongue depressor and press onto skin around anus to look for worms/eggs
describe culture test
swab sample of drainage from throat/mouth/ear/eye/nose/vagina/anus/infected wounds and collected in a culturette and nourished with a crushed ampule and grown with special media/agar
describe sensitivity test
microorganisms are tested w/different antibiotics
what shows an antibiotic is successful in a sensitivity test
zone ring
define PRIMARY MEDIA
grows all microorganisms and gen tryptic soy agar w/5% sheep blood
define SELECTIVE MEDIA
agar gen only encourages growth of gram negative organisms and discourages growth of others
which is gen more dangerous: gram negative or gram positive
gram negative
where is gram negative found
intestinal tract
purpose of thayer-martin plate
isolates gonorrhea
define ENRICHMENT MEDIUM
agar w/additional nutrients
give an example of enrichment medium
chocolate agar
what conditions are gram variable reactions
- mycobacterium (leprosy)
- mycobacterium tuberculosis (TB)
what diseases are gram positive
- bacillus anthracis (anthrax)
- clostridium botulinum (botulism)
- clostridium perfringens (gas gangrene, wound infection)
- clostridium tetani (tetanus)
- corynebacterium diphtheriae (diphtheria)
- staphylococcus aureus (carbuncles, furunculosis, pneumonia, septicemia)
- streptococcus pyogenes (erysipelas, rheumatic fever, scarlet fever, septicemia, strep throat, tonsillitis)
what diseases are gram negative reactions
- bordetella pertussis (pertussis)
- brucella abortus/brucella melitensis/brucella suis (flu-like s/s, fever, arthritis, neurologic, chronic fatigue syndrome, depression, arthritis)
- escherichia coli (urinary infection)
- haemophilus influenzae (meningitis, pneumonia)
- neisseria gonorrhoeae (gonorrhea)
- neisseria meningitidis (nasopharyngitis, meningitis)
- pseudomonas aeruginosa (respiratory & urogenital infection)
- rickettsia rickettsii (rocky mountain spotted fever)
- salmonella paratyphi (food poisoning, paratyphoid fever)
- shigella dysenteriae (dysentery)
- treponema pallidum (syphilis)
- vibrio cholerae (cholera)
- yersinia pestis (plague)
