Introduction To Urinalysis Flashcards
Urine is the ultra-filtrate of __
Plasma
Major inorganic solid dissolved in urine
Chloride
This metabolic waste product produced in the liver accounts for nearly half of the total dissolved solids in urine (primary organic component)
Urea
Give the three organic substances primarily seen in the urine
Urea, creatinine, Uric acid
The normal daily output of urine
1200- 1500 mL ( a range of 600-2000mL is considered normal)
Decreased urine output
Oliguria
Values for oliguria in
- Infants
- Children
- Adults
- Infants: <1 mL/ kg/ hr
- Children: <0.4 mL/ kg/ hr
- Adults: <400mL/ day
Cessation of urine flow
Anuria
Increase in nocturnal excretion of urine is termed as
Nocturia
Increase in daily urine volume
Polyuria
Polyuria is usually associated with the diseases states: __ & __
Diabetes Mellitus & Diabetes Insipidus
- diuretics, caffeine, alcohol = suppress the excretion of antidiuretic hormone which leads to polyuria
How to differentiate DM from DI
DM has a higher specific gravity because of glucose content; DI has a low specific gravity due to dilution
Symptoms of both DM and DI
Polyuria accompanied by Polydipsia
Grounds for rejecting a urine specimen
- Unlabeled containers
- Contaminated
- Requisition form and labels do not match
- Insufficient quantity
- Improperly transported
True / False
You may discard a specimen even before checking with the supervisor if it has grounds for rejection
FALSE. Never discard a specimen before checking with a supervisor
Ideal container capacity for urine specimen
50 mL
A specimen that cannot be delivered and tested within 2 hrs should be __.
Refrigerated
Complete the ff: Changes in unpreserved urine: 1. Color 2. Clarity 3. Odor 4. pH 5. Glucose 6. Ketones 7. Bilirubin 8. Urobilinogen 9. Nitrite 10. RBC & WBC cells Casts 11. Bacteria 12. Trichomonas
- Color —> darkened
- Clarity —> Hazy (decreased)
- Odor —> Increased (breakdown of urea to ammonia)
- pH —> Increased (loss of CO2)
- Glucose —> decreased (bacterial use & glycolysis)
- Ketones —> decreased
- Urobilinogen —> decreased (Oxidation to urobilin)
- Nitrite —> increased (multiplication of nitrate reducing bacteria)
- RBC/WBC cells and casts —> decreased (disintegration due to alkaline urine)
- Bacteria —> increased
- Trichomonas —> lost of motility / death
What is the ideal preservative for urine
Bactericidal, inhibit urease, preserves formed elements
Type of urine specimen for prostatic infection
Three - glass collection
Type of specimen for bladder urine for bacterial culture and cytology
Suprapubic aspiration
Specimen used for routine screening and bacterial culture
Midstream clean- catch
Used for bacterial culture for patients who are bedridden
Catheterized specimen
Type of specimen bused for quantitative chemical tests
24 hr or timed specimen
** because many electrolytes & solutes are diurnal (electrolytes are of highest conc. In the afternoon)
First morning specimen is ideal for: __, __ & __
Routine screening, pregnancy tests, orthostatic proteinuria
The most commonly received urine specimen
Random specimen
In the 24 hour / timed specimen, the patient must begin and end the collection period with an ___ bladder
Empty bladder
True / False
In the three glass collection, the prostrate is massaged before collecting the 2nd sterile container
FALSE. Prostrate is massaged before 3rd glass collection
Give the purpose of the three glass collection :
Glass 1
Glass 2
Glass 3
Glass 1 & 3 : Used to determine the prostatic infection
Glass 2: control for bladder and kidney infection
True / False
If 2nd glass tube (in the 3-glass collection specimen) is POSITIVE, the third glass tube is considered Invalid because infected urine has contaminated the specimen
TRUE
Drug specimen collection documentation from the time of collection to the receipt of results
Chain of Custody
Sample volume obtained for urine drug tests
30-45 mL
In urine drug test, temperature must be taken within __ min. from the time of collection, and must be in the range of __.
4 min, 32.5C-37.7C
Added to the toilet paper stor to prevent adulterated specimen
Blueing agent (dye)
The most sterile urine specimen collected is a
Suprapubic aspiration
Prolonged exposure of a preserved urine specimen to light will cause __
Decreased bilirubin
The primary cause of unsatisfactory results in an unpreserved routine specimen not tested for 8 hrs is:
Bacterial growth
If a patient fails to discard the first specimen when collecting a timed specimen, the specimen must be ___ Because ___
Discarded ; results will be falsely elevated
If a routine urinalysis and a culture are requested on a catheterized specimen, then which should be performed first?
Routine urinalysis
