URINE COLLECTION Flashcards
Reasons for rejecting urine specimen
o Specimens in unlabeled containers
o Nonmatching labels and requisition forms
o Specimens contaminated with feces or toilet paper Containers with contaminated exteriors
o Specimens of insufficient quantity
o Specimens that have been improperly transported
Specimens should be delivered to the laboratory promptly and tested within
2 hours
A specimen that cannot be delivered and tested within 2 hours should be
refrigerated or have an appropriate chemical preservative added
NORMAL URINE COLOR
o Pale yellow
o yellow
o dark yellow
o amber
presence of the abnormal pigment bilirubin.
Dark Yellow or amber
-orange administration of phenazopyridine (Pyridium) or azogantrisin compounds to persons with urinary tract infections.
Yellow
presence of blood
Red
glomerular bleeding
Brown Urine Containing Blood
melanin or homogentisic acid, levodopa, methyldopa, phenol derivatives, and metronidazole (Flagyl).
Brown or black
bacterial infections, including urinary tract infection by
Pseudomonas species and intestinal tract infections resulting in increased urinary indican,
Blue/green
Normal
Aromatic
Bacterial decomposition urinary tract infection
Fruity, Sweet
Foul, Ammonia-like
Ketones ( diabetes mellitus, starvation, vomiting )
Fruity, Sweet
Maple syrup urine disease
Maple Syrup
Phenylketonuria
Mousy
Tyrosinemia
Rancid
Isovaleric Academia
Sweaty feet
Methionine malabsorption
Cabbage
Contamination
Bleach
Consist of chemical-impregnated absorbent pads attached to a plastic strip.
Reagent Strips
Care of Reagent Strips
- Store with desiccant in an opaque, tightly closed container.
- Store below 30C; do not freeze.
- Do not expose to volatile fumes.
- Do not use past the expiration date.
- Do not use if chemical pads become discolored.
- Remove strips immediately prior to use
Aid in determining the existence of systemic acid-base disorders of metabolic or respiratory origin and in the management of urinary conditions that require the urine to
be maintained
PH
slightly acidic ph of 5.0 to 6.0
First morning specimen
4.5 to 8.0.
Normal random samples
Reagents:
methyl red
bromthymol blue
Most indicative of renal disease
PROTEIN
<10 mg/dL or 100 mg per 24 hours
Normal urine
≥30 mg/dL (300 mg/L)
Clinical proteinuria
Highly buffered alkaline urine
Pigmented specimens
Phenazopyridine
Quaternary ammonium compounds (deterg at::
Antiseptics
Chlorhexidine
Loss of buffer from prolonged exposure of the reagent strip to the specimen
High specific gravity
False-positive:
Proteins other than albumin
Microalbuminuria
False Negative
o Most frequent chemical analysis performed on urine.
o Detection and monitoring of diabetes mellitus
GLUCOSE
Contamination by oxidizing agents and detergents
False-positive
High levels of ascorbic acid
High levels of ketones
High specific gravity
Low temperatures
Improperly preserved specimens
False-negative
Represents three intermediate products of fat metabolism
KETONES
intermediate products of fat metabolism:
Acetone
acetoacetic acid
beta-hydroxybutyric acid.
shows a deficiency in insulin, indicating the need to regulate dosage.
It is often an early indicator of insufficient insulin dosage in type 1 diabetes and in patients with diabetes who experience medical problems in addition to diabetes
Ketonuria
- Diabetic acidosis
- Insulin dosage monitoring
- Starvation
- Malabsorption/pancreatic disorders
- Strenuous exercise
- Vomiting
- Inborn errors of amino acid metabolism
Clinical Significance KETONES
May be present in the urine either in the form of intact red
blood cells (hematuria) or as the product of red blood cell
destruction, hemoglobin (hemoglobinuria).
BLOOD
Strong oxidizing agents
Bacterial peroxidases
Menstrual contamination
False-positive
High specific gravity/ crenated cells
Formalin
Captopril
High concentrations of nitrite
Ascorbic acid 25 mg/dL
Unmixed specimens
False-negative
o An early indication of liver disease.
o Often detected long before the development of jaundice
BILIRUBIN
BILIRUBIN Clinical Significance
- Hepatitis
- Cirrhosis
- Other liver disorders
- Biliary obstruction (gallstones, carcinoma)
- Respiratory or metabolic acidosis/ketosis
- Respiratory or metabolic alkalosis
- Defects in renal tubular secretion and reabsorption of acids and bases-renal tubular acidosis
- Renal calculi formation
- Treatment of urinary tract infections
- Precipitation/identification of crystals
- Determination of unsatisfactory specimens
Clinical Significance of Urine pH
o Circulates in the blood en route to the liver, it passes through the kidney and is filtered by the glomerulus.
o Normal value: <1 mg/dl or ehrlich
o Increased urine urobilinogen (greater than 1 mg/dl) is seen in liver disease and hemolytic disorders.
o Measurement of urine urobilinogen can be valuable in the detection of early liver disease
UROBILINOGEN
- Early detection of liver disease
- Liver disorders, hepatitis, cirrhosis, carcinoma
- Hemolytic disorder
UROBILINOGEN Clinical Significance
o More standardized means for the detection of leukocytes.
o Infections caused by trichomonas, chlamydia, yeast, and
inflammation of renal tissues (i.E., Interstitial nephritis) produce leukocyturia without bacteriuria.
LEUKOCYTE ESTERASE
