skills exam 6

Question 1

What is the normal baseline color of urine in a urinalysis? What are abnormal results and what do they indicate?

Answer 1

Normal: light yellow to deep amber

Dark amber: dehydration
Orange: use of Pyridium (medication for UTI)
Red/Pink: blood

Question 2

What is the normal appearance of urine in a urinalysis? What are abnormal results and what do they indicate?

Answer 2

Normal: clear

Cloudiness: possible bacteria, white blood cells, blood, or more

Question 3

What is the normal odor of urine in a urinalysis? What are abnormal results and what do they indicate?

Answer 3

Normal: aromatic/no odor

Malodorous urine: possible infection
Fruit smell: possible Diabetic Ketoacidosis

Question 4

What is the normal pH of urine in a urinalysis? What are abnormal results and what do they indicate?

Answer 4

Normal: 4.5-8.0

pH <4.5: metabolic acidosis
pH >8.0: infection, metabolic alkalosis

Question 5

What is the normal specific gravity of urine in a urinalysis? What are abnormal results and what do they indicate?

Answer 5

Normal: 1.005-1.030

SG <1.005: excessive fluid intake, diabetes mellitus
SG >1.030: dehydration, SIADH, heart failure

Question 6

What are normal results for protein in a urinalysis? What are abnormal results and what do they indicate?

Answer 6

Normal: <20 mg/dL

Persistent proteinuria shows kidney disease, may also be elevated in dehydration or fever

Question 7

What are normal results for glucose in a urinalysis? What do abnormal results indicate?

Answer 7

Normal: negative

If present, excessive glucose in blood; uncontrolled Diabetes Mellitus

Question 8

What are normal results for ketones in a urinalysis? What do abnormal results indicate?

Answer 8

Normal: negative

If present, ketones present in blood; carb-free diets, Diabetes Mellitus

Question 9

What are normal results for bilirubin in a urinalysis? What do abnormal results indicate?

Answer 9

Normal: negative

Excess bilirubin/liver issues if present

Question 10

What are normal results for nitrite in a urinalysis? What do abnormal results indicate?

Answer 10

Normal: negative

Indicates urine infection if positive

Question 11

What are normal results for leukocyte esterase in a urinalysis? What do abnormal results indicate?

Answer 11

Normal: negative

Indicates urine infection if positive

Question 12

What are normal results for RBCs in a urinalysis? What are abnormal results and what do they indicate?

Answer 12

Normal: <5/hpf

If elevated, blood present in urine (kidney stones, trauma, etc.)

Question 13

What are are normal results for WBC in a urinalysis? What are abnormal results and what do they indicate?

Answer 13

Normal: <5/hpf

If elevated, urine infection or inflammation present
Excessive amounts (>15-20) may indicate pyelonephritis present

Question 14

What are normal results for casts in a urinalysis? What do abnormal results indicate?

Answer 14

Normal: none

Indicates urine infection or renal damage if present

Question 15

What is the normal range for BUN?

Answer 15

10-20 mg/dL

Question 16

When is BUN considered critically high?

Answer 16

> 100 mg/dL

Question 17

What is the normal range for serum creatinine?

Answer 17

0.6-1.2 mg/dL

Question 18

When is serum creatinine considered critically high?

Answer 18

> 4mg/dL

Question 19

What is the normal range for eGFR?

Answer 19

> 60mL/min

Question 20

What is the normal range for Creatinine Clearance?

Answer 20

~120mL/min

Question 21

What is the length of a male urethra?

Answer 21

7 to 8 inches

Question 22

What is the length of a female urethra? What are females more at risk for?

Answer 22

2 to 3 inches

Increased risk of UTI because bacteria has a shorter distance to travel

Question 23

What is urinary retention?

Answer 23

An accumulation of urine in the bladder due to the inability of the bladder to empty

Question 24

What does cystitis (lower UTI) affect? What are s/s?

Answer 24

Affects bladder and urethra

Signs and symptoms

• Suprapubic tenderness
• Urinary issues: dysuria, urgency, frequency, incontinence, foul-smelling cloudy urine

Question 25

What does pyelonephritis (upper UTI) affect? What are s/s?

Answer 25

Kidneys affected along with bladder and urethra
If a lower UTI is not treated appropriately, bacteria will travel superior to kidneys

Signs and symptoms

• Those of a lower UTI
• CVA tenderness
• Systemic issues: fever, chills

Question 26

What are UTI s/s common in older adults?

Answer 26

New onset confusion, decreased LOC, agitation

Question 27

What education should the nurse provide for the patient with a UTI?

Answer 27

Take all antibiotics
Prevention:
- educate hygiene (wipe front to back)
- hydration
- void bladder completely

Question 28

What is stress incontinence?

Answer 28

Involuntary urine loss from increasing abdominal pressure; coughing, sneezing, laughing, physical activities

This is the most common form of incontinence!

Question 29

What is urge incontinence?

Answer 29

Involuntary urine loss with abrupt/strong desire to void; unable to make it to the bathroom in time

Most common type of incontinence in older adults

Question 30

What is functional incontinence?

Answer 30

Incontinence due to inability to get to the bathroom, physical limitations, loss of memory (progressed dementia), disorientation

These individuals are usually dependent on others

Question 31

What is overflow incontinence?

Answer 31

Involuntary loss of urine associated with bladder distention, may occur due to prostate enlargement

Question 32

What is total incontinence?

Answer 32

Continuous, unpredictable loss of urine

Neurological impairment, surgery, trauma