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NUR 334: exam 3 > urinary labs > Flashcards

urinary labs Flashcards

1
Q

dark yellow + amber or honey urine

A

dark yellow - normal, probably drink some water
amber/honey - not enough water, drink now

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2
Q

syrup/brown ale urine

A

possibility of liver disease OR severe dehydration
*drink water + see HCP if persist

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3
Q

pink to reddish urine

A

beets, blueberries, rhubarb may change color

possibly blood
sign of kidney disease, tumors, UTI, prostate problems
possible if lead or mercury poisoning

contact HCP

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4
Q

orange urine

A

not drinking enough water
liver or bile duct condition
could be food dye
contact HCP

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5
Q

how is turbidity evaluated?

A

holding the specimen in front of a line of printed material –> urine is graded as clear, slightly cloudy, cloudy, or turbid (very cloudy)

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6
Q

urinary: blood studies

A

Cr
BUN
K
Ca (total)
Phosphorus

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7
Q

creatinine

A

normal: 0.5-1.2 mg/dL

specific to kidneys - more reliable indicator of renal fxn than BUN
breakdown of muscle and protein metabolism and is released at a consistent rate

<0.5: muscle atrophy
>1.2: impaired renal fxn

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8
Q

BUN

A

normal: 10-20 mg/dL

non renal factors: (increase BUN, no inc/dec for Cr)
-high nitrogen TFs or high PRO diet
-GI bleed
-hydration status

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9
Q

potassium

A

normal: 3.5-5
kidneys excrete majority of K+

kidney disease –> K+ is one of the first electrolytes to become abnormal

> 6.0 = cardiac dysrhythmias + muscle weakness

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10
Q

calcium (total)

A

normal: 9-10.5

kidney disease –> decrease reabsorption of Ca leads to “renal osteodystrophy” (weakened bones)

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11
Q

phosphorus

A

normal: 3-4.5

inversely r/t Ca

kidney disease –> typically high bc kidney is primary excretory muscle

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12
Q

magnesium

A

normal: 1.3-2.1

increase with kidney disease because excreted by kidney

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13
Q

urinalysis includes (10)

A

bilirubin, color, glucose, ketones, odor, pH, protein, RBCs, specific gravity, WBCs

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14
Q

considerations of a urinalysis

A

first morning best
analyze within 1 hour

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15
Q

normal findings on an urinalysis

A
  1. bilirubin: none
  2. color: amber yellow
  3. glucose: none
  4. ketones: none
  5. odor: aromatic/none
  6. pH: 4.6-6
  7. protein: zero to trace
  8. RBCs: 0-4
  9. specific gravity: 1.010 - 1.030
  10. WBCs: 0-5
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16
Q

diagnostic studies

A
  1. creatinine clearance
  2. eGFR
  3. bladder scan
  4. urine culture - clean catch
  5. cystoscopy
  6. kidney, ureter, bladder (KUB)
  7. intravenous pyelogram (IVP)
  8. retrograde pyelogram
  9. renal biopsy
  10. non-contrast spiral CT
17
Q

creatinine clearance

A

approximates GFR
24-hr urine collection
discard first urine when begin testing
save all subsequent urine for 24 hours
have patient urinate at end of 24 hours and add to collection
measure serum Cr during 24-hr period

18
Q

considerations with 24-hour urine container

A

keep cold/refrigerated

19
Q

GFR

A

glomerular filtration rate - amount of blood filtered per minute by glomeruli

20
Q

estimated GFR (eGFR)

A

calculation that takes into consideration the patient’s age, sex, weight, ethnicity

21
Q

considerations with 24-hour urine container

A

keep cold/refrigerated

22
Q

bladder scan

A

done at bedside w/ water soluble gel
calculates presence of residual urine

23
Q

clean-catch urine

A

confirms suspected UTI & identifies causative agents
sterile container
cleanse meatus (bladder is sterile; urethra is not)
collect specific 1-2 seconds after voiding starts

24
Q

cystoscopy

A

main goal: inspect interior of bladder wall
lithotomy position
consent form

25
Q

post-cystoscopy procedure

A

expected findings: burning, pink-tinged urine & frequency

NOT normal: bright red blood

26
Q

kidneys, ureter, bladder (KUB)

A

Xray of abd & pelvis
bowel prep
delineates size, shape, and position of kidneys + radiopaque stones (struvite)

27
Q

intravenous pyelogram (IVP)

A

requires bowel prep
check iodine sensitivity (avoid anaphylaxis –> uses contrast)
expect flushed feeling with injection
force fluids afterwards

consider alternative if Cr elevated

*dye injected and kidneys uptake it

28
Q

retrograde pyelogram

A

done if:
-IVP doesn’t visualize good
-pt is allergic to contrast medium
-pt has decreased renal fxn

*cystoscope and urethral catheters are used
*prep same as IVP; complications same as cystoscopy

*dye doesnt get in blood so OK if you have an iodine allergy

29
Q

pyelogram indicates for which part of the body

A

renal pelvis

30
Q

renal biopsy

A

assess coag hx (PT, INR, platelets)
sign consent form
pt not taking ASA or warfarin (thins blood)

performed on the kidney - backside below bottom ribs

31
Q

post-renal biopsy procedure

A

apply pressure dressing
keep on affected side 30-60 minutes
bedrest 24 hours (minimize movement + bleeding)
VS q 5-10 min for 1 hour
assess for flank pain or signs of bleeding
no heavy lifting x7 days

NUR 334: exam 3 (11 decks)

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