Urinalysis overview, color and transparency Flashcards
When to order a urinalysis?
- With certain symptomatic complaints (abdominopelvic pain, flank/back pain, dysuria, polyuria, change in urine color-esp blood)
- May be considered as part of a wellness exam, new pregnancy eval
- Medication copliance
- screening for medication/substance misuse/abuse
- Can also be used to monitor certain conidtions overtime (ex: CKD)
What is the purpose of the urinalysis?
- Detection of substances excreted in urine that reflect physiologic disturbances (glucose, nitrite, ketones, myoglobin)
- Detection of intrinsic renal conditions:
- Markers associated with acute or chronic kidney disease or other diseases that result in failure of the kidney to maintain homeostasis of body fluid volume and composition
What are different types of urine specimens?
Most common:
- Random
- Midstream clean catch
- Pediatric bags
- Catheter
Less common:
- First morning
- fasting
- 2 hour post prandial
- 24 hour timed (ex cortisol)
- Suprapubic puncture (ex of indication: urinary obstruction)
What are ways to order a urinalysis?
- Dipstick urinalysis (UA)
- Dipstick urinalysis w/ reflex to microscopic (micro) if indicated
- Complete urinalysis – this will automatically include a micro
- Complete urinalysis w/ reflex to urine culture
- Urinalysis w/ reflex to micro and/or culture–> what Mr Mcleod prefers
What are primary components of a urinalysis?
- Physical (color, transparency/clarity, odor, volume)
- Microscopic- AKA “formed elements” (WBCs, RBCs, epithelial cells, casts, crystals, microorganisms)
- Chemical reagent (protein, glucose, ketone, bilirubin, pH, blood, nitrite, leukocyte esterase, urobilinogen, specific gravity)
Urine specimen colors
What is the normal color of urine?
“Straw colored and clear”
or
“Yellow and clear”
What does yellow colored urine come from?
Comes from urochrome which is a byproduct of hemoglobin breakdown
What factors alter urine specimen color?
- Change in specific gravity (marker of concentration of urine, increased =darker/more concentrated, decreased= lighter/ less concentrated)
- Foods (e.g. beets – pink or smokey coloration)
- Bilirubin (brown, coca cola colored)
- Medications / supplements:
- Microzide (Hydrochlorothiazide) → diuretic
- Pyridium (Phenazopyridine) → urinary analgesic
Color of urine in relation to dehydration
1-3= adequate hydration
>4= dehydration
Transparency/clarity of urine specimens
- Clear
- Slightly cloudy
- Cloudy
- Turbid (ex: hematuria)
*can also be foamy
What urine transparency/clarity is normal?
clear
What does cloudy to turbid urine indicate?
- WBCs → UTI
- Bacteria → UTI
- Fecal contamination
- Prostatic fluid
- Seminal vesicle fluid
- Vaginal secretions
What does foamy urine indicate?
- Protein
- Bilirubin
- Pneumaturia (air due to rectal-vesicle fistula)
**foamy urine will settle over time but will reform if urine is shaken**
