Urinalysis

Question 1

Why do we undertake urinalysis?

Answer 1

Non-invasive and reliable for diagnosing signs & symptoms of diseases in the early stages
Enables monitoring of wellbeing and deviations from normal

Question 2

What is an MSSU?

Answer 2

Mid-Stream Specimen of Urine

Question 3

What are the three physical characteristics we look for in urine?

Answer 3

Colour - pale/dark?
Clarity - clear/cloudy?
Odour - offensive/sweet?

Question 4

What does dark yellow urine indicate?

Answer 4

Dehydration

Question 5

What does very dark yellow/brown urine indicate? (maybe frothy too)

Answer 5

Bilirubinuria (condition of the liver)

Question 6

What does bright red urine indicate?

Answer 6

Bleeding from bladder

Question 7

What does green urine indicate?

Answer 7

Pseudomonas infection

Question 8

Urine with a sweet odour may indicate what?

Answer 8

Presence of ketones

Question 9

Urine with a fishy/offensive smell may indicate what?

Answer 9

Infection

Question 10

Protein in urine (proteinuria) can indicate what?

Answer 10

Contaminated specimen, renal disease or pre-eclampsia.

Question 11

Ketones in urine (ketonuria) can indicate what?

Answer 11

Excessive breakdown of body fats. This may occur due to fasting, dehydration, vomiting, uncontrolled diabetes.

Question 12

What is the correct procedure for undertaking urinalysis? (10 steps)

Answer 12

1. Check expiry date of reagent strips/dipsticks
2. Obtain informed consent
3. Wash hands/don PPE
4. Observe sample of colour, clarity and odour
5. Completely immerse reagent strip in urine
6. Blot the stick on a paper towel
7. Read the different reagent pads at the time specified
8. Compare the blocks to the colour chart provided
9. Dispose of urine and strip correctly in line with trust policy
10. Wash hands, discuss and document findings, refer on if abnormal as per the NMC Code

Question 13

What can glucose in urine (glycosuria) indicate?

Answer 13

Blood glucose levels rise or if renal absorption lowers.
May indicate gestational diabetes or diabetes, can also be a normal physiological process in pregnancy due to glomerular filtration rate

Question 14

What can blood in urine (haematuria) indicate?

Answer 14

May indicate infection, trauma, tumour or calculi. It may be due to contamination from the vagina or haemorrhoids.

Question 15

What can nitrates in urine indicate?

Answer 15

Urinary tract infection (UTI)

Question 16

What can urobilinogen indicate?

Answer 16

Liver abnormalities/excessive haemolysis

Question 17

What is specific gravity?

Answer 17

This reflects the ability of the kidneys to dilute or concentrate the urine. Low levels associated with water diuresis and high levels with dehydration

Question 18

What can a low pH indicate?

Answer 18

the urine is more acidic than normal and may predispose to the formation of calculi within the bladder or kidney

Question 19

What does bilirubin in urine indicate?

Answer 19

Hepatic or biliary disease