HISTORY AND URINE COMPOSITION,AND HANDLING Flashcards
References to the study of urine can be found in
the drawings of cavemen and in
Egyptian hieroglyphics, such
as the Edwin Smith Surgical Papyrus.
Pictures of early physicians commonly showed them examining a
bladder-shaped
flask of urine
Many well-known names in the history of medicine arE associated with the study of urine, including ______, who,
in the ______, wrote a book on “uroscopy.”
Many well-known names in the history of medicine are
associated with the study of urine, including Hippocrates, who,
in the 5th century BCE, wrote a book on “uroscopy.”
`, physicians concentrated their efforts very intensively on the art of uroscopy, receiving instruction in urine examination as part of their training
During the Middle Ages
, color
charts had been developed that described the significance of
20 different colors
By 1140 CE
Chemical testing progressed from
“_____” and “_________” for glucose to______ discovery in 1694 of _______ by boiling urine
Chemical testing progressed from
“ant testing” and “taste testing” for glucose to Frederik Dekkers’s
discovery in 1694 of albuminuria by boiling urine
became the subject of a book published by Thomas Bryant in 1627.
“pisse prophets,”
became the subject of a book published by
Thomas Bryant in 1627
“pisse prophets,”
The invention of the microscope in the 17th century led
to the examination of urinary sediment and to the development by __________ of methods for quantitating the microscopic sediment.
Thomas Addis
introduced the concept of urinalysis
as part of a doctor’s routine patient examination in 1827.
Richard Bright
Two unique characteristics of a urine specimen account
for this continued popularity
- A urine specimen is readily available and easily collected
- Urine contains information, which can be obtained by
inexpensive laboratory tests, about many of the body’s major metabolic functions.
defines
urinalysis as “the testing of urine with procedures commonly
performed in an expeditious, reliable, accurate, safe, and cost effective manner.”
Clinical and Laboratory Standards Institute (CLSI)
The reasons for performing urinalysis identified by CLSI include
- aiding in the diagnosis of disease,
- screening asymptomatic populations for undetected disorders,
- monitoring the progress of disease and the effectiveness of therapy.
The kidneys continuously form urine as an
ultrafiltrate of
plasma
Reabsorption of water and filtered substances essential
to body function converts approximately __________________
depending on fluid intake.
170,000 mL of
filtered plasma to the average daily urine output of 1200 mL,
Urine is normally ????? although considerable variations in the
concentrations of these solutes can occur due to the influence
of factors such as ???
Urine is normally 95%
water and 5% solutes, although considerable variations in the
concentrations of these solutes can occur due to the influence
of factors such as dietary intake, physical activity, body metab
olism, and endocrine functions.
metabolic waste product produced in the liver
from the breakdown of protein and amino acids
urea
accounts for nearly half of the total dissolved solids in urine
urea
organic substance found in urine
Other organic substances include primarily creatinine and uric acid.
major inorganic solid dissolved in urine is
chloride, fol
lowed by sodium and potassium.
greatly influences the concentra
tions of these inorganic compounds, making it difficult to
establish normal levels.
Dietary intake
urine also may contain formed elements, such as
cells, casts, crystals, mucus, and bacteria.
are
significantly higher in urine than in other body fluids.
Creatinine, urea, sodium, and chloride
re not present in a normal urine specimen.
Protein
and glucose a
Urine volume depends on the
amount of water that the kidneys
excrete
Factors that influence urine volume include
- fluid intake
, - fluid loss from nonrenal sources,
- variations in the se
cretion of antidiuretic hormone (ADH), - need to excrete
increased amounts of dissolved solids, such as glucose or salts.
the normal
daily urine output is usually
1200 to 1500 mL, a range of 600
to 2000 mL is considered normal
Should it be necessary to deter
mine whether a particular fluid is urine, the specimen
can be tested for its
urea and creatinine content.
Because both these substances are present in much
higher concentrations in urine than in other body fluids, a fluid that is high in urea and creatinine
content can be identified as urine
, a decrease in urine output
Oliguria
INFANTS - less than 1 mL/kg/hr
CHILDREN - less than 0.5 mL/kg/hr
ADULTS - less than
400 mL/day
, cessation of urine flow
anuria
result from any serious damage to the kidneys or from a decrease in the flow of blood to the kidneys.
Oliguria leading to anuria,
An increase in the nocturnal ex
cretion of urine is termed
nocturia
, an increase in
daily urine volume
Polyuria
ADULTS = greater than 2.5 L/day
CHILDREN = 2.5 to
3 mL/kg/day
Often associated with diabetes mel
litus and diabetes insipidus; however, it may be induced artificially by diuretics, caffeine, or alcohol, all of which suppress the
secretion of ADH
POLYURIA
result of excessive water loss
from vomiting, diarrhea, perspiration, or severe burns
OLIGURIA
Primary organic component. Product of
metabolism of protein and amino acids
Urea
Product of metabolism of creatine by
muscles
Creatinine
Product of breakdown of nucleic acid in
food and cells
URIC ACIDS
Primary inorganic component. Found in
combination with sodium (table salt)
and many other inorganic substances
CHLORIDE
Primarily from salt, varies by intake
SODIUM
Combined with chloride and other salts
POTASSIUM
Combines with sodium to buffer the
blood
PHOSPHATE
Regulates blood and tissue fluid acidity
AMMONIUM
Combines with chloride, sulfate, and
phosphatE
Calcium
results from a decrease in the pro
duction or function of ADH; thus, the water necessary for
adequate body hydration is not reabsorbed from the plasma
filtrate
Diabetes insipidus
In this condition, the urine is truly dilute and has
a low specific gravity
Diabetes insipidus
increased ingestion of water
polydipsia
RECOMMENDED CONTAINER CAPACITY FOR URINE SPECIMEN
The recommended capacity of the container is 50 mL, which allows 12 mL of specimen needed for microscopic analysis, additional specimen for repeat analysis, and enough room for `the specimen to be mixed by swirling the container
is a nonsterile, plastic holder device that contains a needle with a straw attachment that can
be used with the collection container to fill evacuation tubes
BD
Vacutainer Urine Transfer Straw
BD
Vacutainer Urine Transfer Straw
This device allows for the sterile transfer of urine to
TUBES w/ PRESERVATIVES = for microbiology testing
TUBE WITH CONICAL BOTTOM = for sediment analysis or
ROUND BOTTOM = for automated reagent strip testing
The information on the
form must match the information on the specimen label
Requisition Form
Specimen Rejection
- Specimens in containers that are unlabeled or
improperly labeled - Labels and requisition forms that do not match
- Specimens contaminated with feces or toilet paper
- Containers with contaminated exteriors
- Specimens of insufficient quantity
- Specimens that have been transported improperly
- Specimens that have not been preserved correctly during
a time delay - Specimens for urine culture collected in a nonsterile
container - Inappropriate collection for the type of testing needed
(for example, midstream clean-catch specimen for
bacterial culture)
