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sav nur 334 exam 3 week 4 > Urinary Labs & Diagnostics > Flashcards

Urinary Labs & Diagnostics Flashcards

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1
Q

what would the nurse expect NORMAL urine to look like?

A

Light yellow to light amber, typically clear

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2
Q

what does turbid urine mean?

A

Super cloudy

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3
Q

which foods could potentially turn your urine pink to red?

A

Beets, blueberries, or rhubarb

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4
Q

what does dark yellow urine indicate?

A

Dark urine indicates concentrated urine; the patient needs to drink water.

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5
Q

what does amber or honey urine indicate?

A

Your body isn’t getting enough water, drink some now!

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6
Q

what does syrup or brown ale colored urine indicate?

A

You could have liver disease, or severe dehydration. Drink water and see PCP if it persists.

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7
Q

what does pink to reddish colored urine indicate?

A

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.

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8
Q

what does orange colored urine indicate?

A

Possible dehydration, but also could be liver or bile duct condition. See doctor.

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9
Q

Which labs would we check for with urinary conditions?

A
  • Creatinine
  • BUN (blood urea nitrogen)
  • Potassium
  • Calcium
  • phosphorus
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10
Q

what is a normal creatinine lab value?

A

0.5-1.2 mg/dL

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11
Q

what is the most reliable indicator of renal function?

A

Creatinine, BUN can be influenced by fluid status.

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12
Q

what is creatinine?

A

breakdown of muscle & protein metabolism and is released at a consistent rate

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13
Q

would creatinine be HIGH or LOW with decreased kidney function?

A

HIGH! Kidneys are unable to eliminate toxins so they build up.

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14
Q

what condition could lead to LOW creatinine?

A

Muscle atrophy, otherwise a low creatinine is insignificant. Remember, it’s HIGH with decreased kidney function.

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15
Q

what is a normal blood urea nitrogen (BUN)

A

10-20 mg/dL

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16
Q

what are some non-renal factors that can cause a high BUN

A
  • high nitrogen tube feedings/high protein diet
  • GI bleeds
  • dehydration (false high)
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17
Q

what is a normal potassium lab value

A

3.5-5.0 mEq/L

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18
Q

what is the first electrolyte to become abnormal when kidney function is compromised?

A

K+

Why? b/c the kidneys excrete majority of potassium

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19
Q

what would you worry about with a K+ that is GREATER than 6.0

A

cardiac dysrhythmias

muscle weakness

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20
Q

what is a normal calcium lab value

A

9.0-10.5 mEq/L

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21
Q

in kidney disease, would we expect ca to be high or low

A

low

22
Q

what does low ca in kidney disease cause

A

renal osteodystrophy – leading to potential bone breaks

23
Q

what is the normal phosphorous lab value

A

3.0-4.5 mEq/L

24
Q

which too electrolytes have an INVERSE relationship

A

calcium & phosphorus– meaning if ca is low, then phosphorous will be high and vice versa

25
Q

would phosphorous be high or low with kidney disease

A

high! kidneys are the primary excretor of phosphorous, plus we know that kidney disease causes low ca so due to their inverse relationship this makes sense

26
Q

what is the normal lab value for magnesium

A

1.3-2.1 mEq/L

27
Q

will magnesium increase or decrease with kidney disease

A

increase! mg is excreted by the kidneys

28
Q

what urine is BEST for a urinalysis

A

first morning urine

29
Q

what are normal urinalysis values

A 
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
30
Q

what are some urinary diagnostic studies

A
  • 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
31
Q

what does a creatinine clearance show

A

Approximates GFR (amount of blood filtered per minute by glomeruli)

32
Q

how long do you collect urine for a creatinine clearance?

A

24 hours
discard FIRST urine when beginning testing
save all urine for 24 hours
at end of 24 hours, have patient urinate and add to collection
check serum creatinine in middle of 24 hour period

33
Q

T/F: 24-hour urine container for a creatinine clearance should be kept at room temperature

A

False – refrigerate.

34
Q

T/F: At the end of the 24 hour urine collection the nurse should have the patient void and dispose of this urine.

A

False– should add to the 24 hour collection, but yes have them urinate at the end and ADD it.

35
Q

what variables are taken into consideration with an estimated GFR

A

age, sex, weight, and ethnicity

36
Q

what does a bladder scanner do

A

calculates presence of residual urine

37
Q

What are the appropriate steps to ensure a urine collection is CLEAN CATCH

A
  1. Wipe from front to back to clean the urinary meatus
  2. Pee for 1-2 seconds into the toilet before you begin to collect
  3. Collect into a sterile container
38
Q

what is the main goal of a cystoscopy

A

to inspect interior of bladder wall

39
Q

what should the patient expect POST cystoscopy

A

burning, pink tinged urine & frequency

40
Q

is bright red blood normal after a cystoscopy

A

NO! pink tinged it ok, but not bright red

41
Q

what is a KUB (kidneys, ureters, bladder)?

A

an x-ray of abdomen and pelvis

42
Q

do you need a bowel prep for a KUB?

A

Yes, stool could block what we need to see

43
Q

what should the patient expect anytime contrast dye is used?

A

a flushed feeling with injection

44
Q

what allergies should you check before contrast dye is used

A

iodine

45
Q

what should you recommend the patient does after a procedure with contrast dye

A

push fluids, dye is nephrotoxic

46
Q

do you need a bowel prep for intravenous pyelogram?

A

yeS! stool could cover what we need to see

47
Q

when would we use a retrograde pyelogram?

A

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

48
Q

what is a retrograde pyelogram

A

a cystoscope and urethral catheter is inserted and looks backwards up through the kidneys

49
Q

what labs should you check prior to a renal biopsy and why?

A

INR, PT, coags, platelets

b/c kidneys are super vascular and high risk of bleeding

50
Q

Post renal biopsy instructions

A
  • 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
51
Q

position for renal biopsy

A

tilted on table to open up intercostal spaces

52
Q

what is the gold standard for diagnosing renal colic symptoms

A

non-contrast spiral CT

it is quick, non-invasive, and no IV contrast!!

sav nur 334 exam 3 week 4 (7 decks)

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