Intro to Urinalysis Flashcards
What are 4 reasons for performing urinalysis identified by CLIS?
- Disease diagnosis
- Screening asympomatic populations for undetected disease
- Monitoring disease progress
- Monitoring effectiveness of therapy
Kidneys have two types of nephrons, what are they and what are their function.
-
Cortical nephrons (85% nephrons)
- remove waste
- reabsorb nutrients
-
Juxtamedullary nephrons
- Longer loops of Henle
- Primary function is to concentrate urine
What influences the final concntration of urine?
reabsorbtion which depends on osmotic gradient in medulla and ADH.
In general urine consists of?
- urea and other organic and inorganic chemicals dissolved in water
Urine is normally _____ water and _____ solutes.
- 95%
- 5%
What factors cause variations in concentration of solutes in urine? (4)
- Dietary intake
- Physical activity
- Metabolism
- Endocrine function
What are the two substances used to deterine if a fluid is urine?
- Creatinine
- Urea
What is the normal daily urine output?
What range is considered normal?
- 1200 - 1500 mL
- 600 - 2000 mL
What is Oliguria?
- A urine output <400 mL in adults
- <1 mL/kg/hr in children
- <0.5 mL/kg/hr in infants
Oliguria can lead to Anuria, which is?
the cessation of urine flow, whihc may be because of serios kidney damage or decrease in blood flow to kidneys.
What is Polyuria?
AN increase in daily urine volume, greater 2.5 L in adults and 2.0 - 3.0 mL/kg/day in children.
Polyuria is often associated with??
- Diabetes mellitus
- Diabetes insipidus
- artificailly induced by diuretics, caffiene, or alcohol which suppress ADH.
Urine from a patiant with diabetes has a?
- High specific gravity
- Increased glucose content
Urine from a patient with diabetes insipidus has a?
Because?
Low specific gravity, urine is truly dilute
Fluid loss in Diabetes mellitus and Diabetes insipidus is compensated by?
Polydipsia (increased water intake) leading to greater urine volume.
Following collection, specimens should be delivered to the lab within what time frame?
If a specimen cannot be delivered and tested within the given time frame, what should be done?
- 2 hours
- refridgerated or a chemical preservative added
Most changes are related to prescence and growth of bacteria.
- Increases: colour, TBD, pH, nitrite, bacteria, odour
- Decreases: Clarity, glucose, keytones, bilirubin, urobilinogen, RBC and WBC casts, and trichomonas
What temperature is refridgeration?
What does refridgeration decrease?
- 2 - 8 oC
- bacterial growth and metabolism
What type of specimen is essential for preventing false-negative preganancy tests, is the ideal screening specimen, and is used for evaluating orthostatic pressure?
First morning specimen
When might a 24 hour speciment collection be required?
Whn the concentration of the substance to be measured changes with diurnal variations and daily activities, such as exercise, meals and body metabolism.
To obtain and accurate timed 24 hour speciment the patient must begin and end the collection period with?
an empty bladder
Describe a catheterized specimen?
A specimen collected user sterile conditions by passion a hollow tube throughthe ureathra into the bladder.
What is the most commonly requested test on a catheterized specimen and done before routine analysis?
bacterial culture
Desribe a midstream clean catch?
Less traumatic method of getting pee for bacterial culture, less contaminated by bacteria and epithlial cells.
- clean genitals w/ towlette
- begin peeing
- collect from midstream
- finish peeing
Prostatitis: Describe the Three-Glass Collection Method?
Clean area w/ mid male midstream catch
- Cup 1 - first pee collected
- Cup 2 - midstream catch
- Cup 2 - prostate massaged so prostate juice colllected with rest of pee.
Three-Glass Collection Method, what will be contained in the 3rd speciment in prostatic infection?
WBC high power field count and bacterual count 10x first specimen
In the Three-Glass Collection Method, which specimen is used as a control for kidney and bladder infection?
Second specimen
Three-Glass Collection Method: If speciment 2 is positive what does this mean for the results from the 3rd specimen?
results invalid bacause infected urine has contaminated the specimen
Prostatitis: Pre and Post Massage Test (PPMT)
Describe the above test?
What indicates a positive result?
- Cup 1 - clean midstream catch
- Cup 2 - second sample collected after protate massaged
- significant bacteruria greater than 10x pre-massage count
How is a pediatric specimen collected?
Sterile adhesive bag.
What are the three types of drug specimen collection?
- Chain of Custody (COC)
- Witnessed
- Unwitnessed
Describe COC specimen collection?
- Process of documentation of sample identifiction from collection to receipt of lab results ,
- allows urine to widstand legal scutiny
- ensures no unathorized access to sample was possible.
- Witnessed
In a witnessed or unwitnessed specimen collection, how soon should the temperature be checked?
What is the temperature range?
- Within 4 minutes of collection
- Temp 32.5 - 37.7 oC
