Module 10 Flashcards
What is routine urinalysis and the procedures commonly performed?
Testing of urine.
Macroscopic evaluation.
Physical measurements.
Chemical reagent strip testing.
Microscopic evaluation.
What should urinalysis reqs have?
Patient name
Date of birth
Patient location
ID number
Accession number
Physician
Diagnosis or major symptoms
Urinalysis reqs are designed to include what?
Specimen type
Date and time the collection is required
Actual date and time of collection
Whether the sample was refrigerated
Time the specimen was received
What specific situations should be noted on the req?
Preservatives
Medications
Menstruation
Strenuous exercise prior
Other clinical info
What are the characteristics of a proper urine container?
Leakproof, clean, clear disposable material
Inert material
Sterile for micro or if >2hrs before analysis
50-100mL
What kind of collection methods for urinalysis are there?
Routine/regular void
Midstream urine/clean catch
Catheter specimens
Suprapubic aspiration
Paediatric
What is the purpose of random urine collection?
General screen for physical health.
Several hours of urinary continence is desirable.
Conditions may be missed because the urine isn’t concentrated enough.
What is a UBAG and when is it used?
Bag for collection
Used with young patients
12mL must be collected
What is a first morning/8hr urine? What is it used for?
The most concentrated specimen, more likely to contain abnormal specimens.
Pregnancy testing
Cytology (increased number of epithelial cells)
When are specimens to confirm orthostatic proteinuria collected?
After 8hrs lying down
What are timed specimens?
Collected at specific times in the 24hr period or at a specific time in relation to another activity.
What collections may require supervision?
Midstream/clean catch
Specimen for microbiological culture
Paediatric
What is the purpose of MSU/clean catch?
Used for for routine microbiological culture and sensitivity.
Avoids sources of external bacteriological contamination.
What are the types of assisted collections?
Catheter- collected directly from the bladder, collect from outflow line
Suprapubic- collected directly from bladder by puncturing the abdominal wall by the physician, uncontaminated specimen
How are specimens stored prior to testing?
If not tested within 2hrs, should be refrigerated.
Refrigeration may ppt some crystals.
Room temperature for analysis.
Aliquoting may be required.
What may happen if urine is allowed to stand?
Bacteria can destroy glucose.
pH changes can occur.
What compounds is refrigeration not adequate for?
Bilirubin and urobilinogen.
They are unstable.
How can microbiology specimens be handled?
Refrigerated until culture.
Aliquoted with bacteriostatic preservative.
Inoculated to a dip slide.
What are specimens inspected for once they’re received?
Proper labelling
Elapsed time between collection and receipt
Refrigeration or the presence of preservative
Container suitability/condition
Adequate volume
Absence of contaminants
Chemical preservative consistent with intended specimen use
What information does QA ensure is documented?
Specimen type is correct
Labels are correct
Collection techniques are correct
Containers are suitable
Volume is adequate
Transportation is timely
Inspection after arrival
Storage is correct
What is a 24hr urine? What is it used for?
Total volume of urine voided in a 24hr period.
Many substances exhibit circadian/diurnal variation.
Used to evaluate renal clearance, hormone levels, glucose loss.
How are 24hr urine samples preserved?
Preservative depends on substance to be analyzed.
Minimizes oxidation and bacterial growth.
Acidic or alkaline conditions may be required.
Organic solvents (toluene)- protects the specimen from oxidation
HCl- 5-HIAA
What is required on the 24hr urine label?
WHMIS label for preservative.
How is a 24hr urine collected?
Discard first sample and note time.
Collect all voids for 24hrs.
Do not rinse or discard.
What diet restrictions are there for 24hr urine collections?
24hr catecholamine/metanephrine- withdraw from meds for 72-96hrs prior and during
24hr uric acid- 3 days prior eat one meat serving/day, avoid alcohol, aspirin, aceytlsalicylic acid, phenylbutazone, liver, kidney, sweet breads, heart, herring, sardines, anchovies and caviar
24hr serotonin (5-HIAA)- abstain from bananas, avocados, plums, eggplants, tomatoes, cough syrup, other meds for 72-96hrs
How are urine collections completed?
Record total volume (cylinder or weight)
Determine pH
Determine the number of aliquoted required
How are samples weighed?
Assume 1mL of water weighs 1g.
Use specific gravity (weight divided by specific gravity).
Minus container weight.
What are aliquot containers labelled with for urine?
Patient name
ID number
Accession number
Volume of 24hr sample
pH
Test requested
How are aliquots pH adjusted?
If collected without preservative.
Add preservative until pH is in a specific range.
How are samples disposed of?
Flush down designated sink with water.
Containers in biohazard.
What is the purpose of urinalysis?
Aids in disease diagnosis.
Screens population for asymptomatic, congenital or hereditary diseases.
Monitors the progress of disease.
Monitors the effectiveness or complications of therapy.
