Intro to Urinalysis

Question 1

What are 4 reasons for performing urinalysis identified by CLIS?

Answer 1

• Disease diagnosis
• Screening asympomatic populations for undetected disease
• Monitoring disease progress
• Monitoring effectiveness of therapy

Question 2

Kidneys have two types of nephrons, what are they and what are their function.

Answer 2

• ​Cortical nephrons (85% nephrons)
  
  • remove waste
  • reabsorb nutrients
• Juxtamedullary nephrons
  
  • Longer loops of Henle
  • Primary function is to concentrate urine

Question 3

What influences the final concntration of urine?

Answer 3

reabsorbtion which depends on osmotic gradient in medulla and ADH.

Question 4

In general urine consists of?

Answer 4

• urea and other organic and inorganic chemicals dissolved in water

Question 5

Urine is normally _____ water and _____ solutes.

Answer 5

• 95%
• 5%

Question 6

What factors cause variations in concentration of solutes in urine? (4)

Answer 6

• Dietary intake
• Physical activity
• Metabolism
• Endocrine function

Question 7

What are the two substances used to deterine if a fluid is urine?

Answer 7

• Creatinine
• Urea

Question 8

What is the normal daily urine output?

What range is considered normal?

Answer 8

• 1200 - 1500 mL
• 600 - 2000 mL

Question 9

What is Oliguria?

Answer 9

• A urine output <400 mL in adults
• <1 mL/kg/hr in children
• <0.5 mL/kg/hr in infants

Question 10

Oliguria can lead to Anuria, which is?

Answer 10

the cessation of urine flow, whihc may be because of serios kidney damage or decrease in blood flow to kidneys.

Question 11

What is Polyuria?

Answer 11

AN increase in daily urine volume, greater 2.5 L in adults and 2.0 - 3.0 mL/kg/day in children.

Question 12

Polyuria is often associated with??

Answer 12

• Diabetes mellitus
• Diabetes insipidus
• artificailly induced by diuretics, caffiene, or alcohol which suppress ADH.

Question 13

Urine from a patiant with diabetes has a?

Answer 13

• High specific gravity
• Increased glucose content

Question 14

Urine from a patient with diabetes insipidus has a?

Because?

Answer 14

Low specific gravity, urine is truly dilute

Question 15

Fluid loss in Diabetes mellitus and Diabetes insipidus is compensated by?

Answer 15

Polydipsia (increased water intake) leading to greater urine volume.

Question 16

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?

Answer 16

• 2 hours
• refridgerated or a chemical preservative added

Question 17

Answer 17

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

Question 18

What temperature is refridgeration?

What does refridgeration decrease?

Answer 18

• 2 - 8 ^oC
• bacterial growth and metabolism

Question 19

What type of specimen is essential for preventing false-negative preganancy tests, is the ideal screening specimen, and is used for evaluating orthostatic pressure?

Answer 19

First morning specimen

Question 20

When might a 24 hour speciment collection be required?

Answer 20

Whn the concentration of the substance to be measured changes with diurnal variations and daily activities, such as exercise, meals and body metabolism.

Question 21

To obtain and accurate timed 24 hour speciment the patient must begin and end the collection period with?

Answer 21

an empty bladder

Question 22

Describe a catheterized specimen?

Answer 22

A specimen collected user sterile conditions by passion a hollow tube throughthe ureathra into the bladder.

Question 23

What is the most commonly requested test on a catheterized specimen and done before routine analysis?

Answer 23

bacterial culture

Question 24

Desribe a midstream clean catch?

Answer 24

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

Question 25

Prostatitis: Describe the **Three-Glass Collection Method**?

Answer 25

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.

Question 26

Three-Glass Collection Method, what will be contained in the 3rd speciment in prostatic infection?

Answer 26

WBC high power field count and bacterual count 10x first specimen

Question 27

In the Three-Glass Collection Method, which specimen is used as a control for kidney and bladder infection?

Answer 27

Second specimen

Question 28

Three-Glass Collection Method: If speciment 2 is positive what does this mean for the results from the 3rd specimen?

Answer 28

results invalid bacause infected urine has contaminated the specimen

Question 29

Prostatitis: Pre and Post Massage Test (PPMT) Describe the above test? What indicates a positive result?

Answer 29

* Cup 1 - clean midstream catch * Cup 2 - second sample collected after protate massaged * significant bacteruria greater than 10x pre-massage count

Question 30

How is a pediatric specimen collected?

Answer 30

Sterile adhesive bag.

Question 31

What are the three types of drug specimen collection?

Answer 31

* Chain of Custody (COC) * Witnessed * Unwitnessed

Question 32

Describe COC specimen collection?

Answer 32

* 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

Question 33

In a witnessed or unwitnessed specimen collection, how soon should the temperature be checked? What is the temperature range?

Answer 33

* Within 4 minutes of collection * Temp 32.5 - 37.7 ^oC