UA labs Flashcards
what would the nurse expect NORMAL urine to look like?
Light yellow to light amber, typically clear
what does turbid urine mean?
Super cloudy
which foods could potentially turn your urine pink to red?
Beets, blueberries, or rhubarb
what does dark yellow urine indicate?
Dark urine indicates concentrated urine; the patient needs to drink water.
what does amber or honey urine indicate?
Your body isn’t getting enough water, drink some now!
what does syrup or brown ale colored urine indicate?
You could have liver disease, or severe dehydration. Drink water and see PCP if it persists.
what does pink to reddish colored urine indicate?
Possibly from recent ingestion of beets, blueberries, or rhubarb. If not, then could be blood in your urine which could indicate kidney disease, tumors, UTI, prostate problems or something else. Could indicate lead or mercury poisoning. See doctor.
what does orange colored urine indicate?
Possible dehydration, but also could be liver or bile duct condition. See doctor.
Which labs would we check for with urinary conditions?
- Creatinine-BUN (blood urea nitrogen)
- Potassium
- Calcium
- phosphorus
what is a normal creatinine lab value?
0.5-1.2 mg/dL
what is the most reliable indicator of renal function?
Creatinine,
BUN can be influenced by fluid status.
what is creatinine?
breakdown of muscle & protein metabolism and is released at a consistent rate
would creatinine be HIGH or LOW with decreased kidney function?
HIGH! Kidneys are unable to eliminate toxins so they build up.
what condition could lead to LOW creatinine?
Muscle atrophy, otherwise a low creatinine is insignificant.
Remember, it’s HIGH with decreased kidney function.
what is a normal blood urea nitrogen (BUN)
10-20 mg/dL
what are some non-renal factors that can cause a high BUN
- high nitrogen tube feedings/high protein diet
- GI bleeds
- dehydration (false high)
what is a normal potassium lab value
3.5-5.0 mEq/L
what is the first electrolyte to become abnormal when kidney function is compromised?
K+
Why? b/c the kidneys excrete majority of potassium
what would you worry about with a K+ that is GREATER than 6.0
cardiac dysrhythmias
muscle weakness
what is a normal calcium lab value
9.0-10.5 mEq/L
in kidney disease, would we expect ca to be high or low
low
what does low ca in kidney disease cause
renal osteodystrophy -
- leading to potential bone breaks
what is the normal phosphorous lab value
3.0-4.5 mEq/L
which too electrolytes have an INVERSE relationship
calcium & phosphorus– meaning if ca is low, then phosphorous will be high and vice versa
would phosphorous be high or low with kidney disease
high! kidneys are the primary excretors of phosphorous, plus we know that kidney disease causes low ca so due to their inverse relationship this makes sense
what is the normal lab value for magnesium
1.3-2.1 mEq/L
will magnesium increase or decrease with kidney disease
increase! mg is excreted by the kidneys
what urine is BEST for a urinalysis
first morning urine
what are normal urinalysis values
bilirubin- none color -- amber yellow glucose-- none ketones-- none odor-- aromatic pH 4.6-6.0 proteins-- zero to trace RBCs 0.4/hpf specific gravity 1.010-1.030 WBCs 0.5/hpgf
what are some urinary diagnostic studies
- creatinine clearance vs. eGFR
- bladder scan
- urine culture (clean-catch)
- cystoscopy
- kidney, ureter, bladder (KUB
- intravenous pyelogram (IVP)
- retrograde pyelogram
- renal biopsy
- non-contrast spiral CT
what does a creatinine clearance show
Approximates GFR (amount of blood filtered per minute by glomeruli)
how long do you collect urine for a creatinine clearance?
24 hours
discard FIRST urine when beginning testing
save all urine for 24 hour
sat end of 24 hours, have patient urinate and add to collection
check serum creatinine in middle of 24 hour period
T/F: 24-hour urine container for a creatinine clearance should be kept at room temperature
False – refrigerate.
T/F: At the end of the 24 hour urine collection the nurse should have the patient void and dispose of this urine.
False– should add to the 24 hour collection, but yes have them urinate at the end and ADD it.
what variables are taken into consideration with an estimated GFR
age, sex, weight, and ethnicity
what does a bladder scanner do
calculates presence of residual urine
What are the appropriate steps to ensure a urine collection is CLEAN CATCH
- Wipe from front to back to clean the urinary meatus 2. Pee for 1-2 seconds into the toilet before you begin to collect3. Collect into a sterile container
what is the main goal of a cystoscopy
to inspect interior of bladder wall
what should the patient expect POST cystoscopy
burning, pink tinged urine & frequency
is bright red blood normal after a cystoscopy
NO! pink tinged it ok, but not bright red
what is a KUB (kidneys, ureters, bladder)?
an x-ray of abdomen and pelvis
do you need a bowel prep for a KUB?
Yes, stool could block what we need to see
what should the patient expect anytime contrast dye is used?
a flushed feeling with injection
what allergies should you check before contrast dye is used
iodine
what should you recommend the patient does after a procedure with contrast dye
push fluids, dye is nephrotoxic
do you need a bowel prep for intravenous pyelogram?
yeS! stool could cover what we need to see
when would we use a retrograde pyelogram?
if:
- IVP doesn’t visually adequately
- pt allergic to contrast-
- b/c here we use contrast but it doesn’t get into blood stream
- if patient has decreased renal function
what is a retrograde pyelogram
a cystoscope and urethral catheter is inserted and looks backwards up through the kidneys
what labs should you check prior to a renal biopsy and why?
INR, PT, coags, platelets b/c kidneys are super vascular and high risk of bleeding
Post renal biopsy instructions
- apply pressure dressing
- keep on affected side for 30-60 min
- bedrest 24 hours
- vs q 5-10 min x 1 hour-assess for flank pain
position for renal biopsy
tilted on table to open up intercostal spaces
what is the gold standard for diagnosing renal colic symptoms
non-contrast spiral CTit is quick, non-invasive, and no IV contrast!!
