Urine 1 Flashcards
signs and symptoms to order a UA
frequent urination inability to urinate polydipsia (excessive thirst) polyphagia (excessive hunger) physicals and wellness screening
what percent of CO perfuse the kidneys every minute?
25%
what are kidneys involved in the production of?
erythropoitin, renin
erythropoitin
a hormone that stimulates RBC production
rening
an enzyme for controlling blood pressure
routine UA consists of
physical properties
chemical proerties
microscopic properties
functional unit of the kidney is?
nephron
how many nephrons are there per kidney? What does a nephron consist of?
1 million
proximal convoluted tubule, loop of Henle, descending and ascending limb, distal tubule, collecting duct
what is the oldest lab procedure?
UA
when does the glomerular filtrate become urine?
after it leaves the distal convoluted tubule
what are the prinicple solutes of urine?
urea sodium chloride potassium creatinine uric acid ammonia
the body excretes approximately __g of dissolved material in 24 hours. how much of it is urea?
60 grams
1/2 is urea
what is urine composed of?
95% water and 5% dissolved solids
average daily volume of urine?
1200-1500ml
normal range is 600-2000ml/day
polyuria
> 2000ml/24hours
polyuria can be due to
diabetes mellitus
diabetes insipidus
large fluid intake
diuretics
oliguria
<500mL/24hours
oliguria can be due to
renal tubule dysfunction end stage renal disease obstruction edema dehydration diarrhea vomiting shock
anuria
abscence of urine
anuria can be due to
renal failure
obstruction
heart attack
what specimen is the best for urinalysis
early morning urine
how should you catch urine?
clean area
start stream, then catch midstream
how soon should you test urine?
within 30 minutes at room temp
within 4 hours if referigerated
what is the most common and convienent urinalysis
random sample
what is the best urinalysis?
24 hour sample with preservative
what happens to urine as it sits out if it is unpreserved?
color becomes darker turbidity increases odor is more foul smelling pH increases glucose, ketones, bilirubin and urobilinogen decrease nitrites and bacteria increase RBCs lyse WBCs and casts disintegrate
what does urine color depend on?
degree of hydration and concentration
what is the normal color of urine?
straw to amber (light yellow to dark yellow)
red/dark brown urine means?
found with excessive hemoglobin, RBC, myoglobin
(ex)menses, UTI, malignancy, prostate, etc
what consistutes as “smoky urine”
yellow urine+red blood= smoky urine
orange urine is found with
dehydration from fever, vomiting, certain foods (rhubarb, vit. c, carrots), medications, etc
bright yellow urine is found with
excessive vitamin B intake
black urine is found with
alkaptonuria
malignant melanoma
do people pee black urine?
no, if it sits long enough, then it turns black
what is alkaptonuria?
a disease where you can’t process amino acids
ochronosis- lack of homoegentistic oxidase
discs are calcified
what color is associated with liver problems?
brownish yellow/brownish green/greenish yellow, yellowish green
may also be referred to as dark yellow
what should you check if you suspect liver problems?
bilirubin, urobilinogen
may also see jaundice of skin and sclera
milky urine is associated with?
hyperlipidemia
clear urine
normal
slightly hazy urine
usually normal (check sediment, if negative then insignificant
cloudy urine
may be pus, bacteria, RBCs, spermatozoa
if associated with crystals, usually insignificant
turbidity
how clear the urine is
hazy/cloudy urine
usually due to infection
frothy urine
assoicated with proteins
if yellow froth- billirubin
what do they need to do if there is a change in turbidity
need to look microscopically at urinary sediment
specific gravity
evaluates kidney’s ability to concentrate urine
what is an early sign of kidney disease
inability to concentrate urine
what is the nomal SpG for an adult
1.015-1.035
what do we compare the weight of urine to?
distilled water
what do we use to measure the SpG?
urinometer/refractometer or dipstick
hyposthenuria
low specific gravity
hypersthenuria
high SpG
isosthenuria
fixed SpG at 1.010 same as protein free plasma and signifies end stage of renal failure
ONLY if they consistently have an SpG of 1.010
what does increased specific gravity indicate?
concentrated urine proteinuria glucosuria dehydration (fever, vomiting, diarrhea) decreased renal blood flow (heart failure, renal artery stenosis)
what does decreased specific gravity mean?
dilute urine decreased concentration overhydration glomerulonephritis pyleonephritis diabetes insipidus renal failure
when is the odor of the urine concerning?
foul, fishy (UTI)
fruity, sweet (diabetes mellitus/ketosis)
feces odor (asparagus, enterobladder fistula)
what is important to know when using dipsticks?
need to be precise in timing
urine pH often indicates?
renal or lung disease
normal pH range
4.5-7.5
acidic pH
<7
alkaline pH
> 7
urine becomes alkaline as it stands due to?
bacterial growth and breakdown of urea
normal blood pH
7.35-7.45
how do we maintain normal pH
primarily through reabsorption of sodium and secretion of hydrogen and ammonium oins
what diets are typically acidic?
high in animal products
what diet is typically alkaline
citrus fruits and vegetables
what situations usually have acidic pH?
respiratory acidosis (emphysema)
metabolic acidosis (diabetic ketoacidosis)
diabetes mellitus
large amounts of meats and cranberries
what situations usually have alkaline pH?
respiratory alkalosis
metabolic alkalosis
UTI
diet high in vegetables and citurs fruits
what is the most common bacteria to cause UTI?
e coli
