Urine dip and analysis Flashcards
What equipment do you need for a urinalysis?
Alcohol gel gloves apron urine dipsticks urine sample paper towels
How do you inspect urine?
Wash hands, don gloves and apron
confirm patient details are correct on the sample bottle (name, dob, hosp #)
Colour- straw= norm / dark conc urine; dehy / red- maroscopic haem, rifapicin, porphyra, beetroot / brown - bile pigments, myoglobin, antimalarials
Clarity: clear, cloudy/debris, frothy - nephrotic
How do you perform a urine dipstick test?
Check urine expiry date
remove testing strip w/o touching testing zones
insert test strip (inc all testing zones)
remove the strip, ensuring tap off residual urine before removing from the sample bottle
test strip horizontal (prevents x contam of testing zones)
different tests on the strip are req to be read at differnt times so interpret appropriate at correct time e.g. 60s for protein (will say under each test name on the bottle in s)
interpret using dipstick analysis guide on the side of the testing strip container to interpret the findings
once all tests interpreted, discard the strip into clinical waste bin along with gloves and apron
wash hands
How do you complete a urine dip?
Summarise findings
Document urinalysis results
indicate that depending on the results further investigations maybe required
If high WCC / Leukocytes ?UTI - send urine for culture Mid Stream Urine /Catheter Specimen Urine
high glucose - ? diabetes - capillary blood glucose
What is on a urine dipstick?
pH Specific gravity Blood Protein Leukocyte esterase Nitrites Ketones Glucose Bilirubin Urobilinogen
What does pH indicate?
indicates acidity of urine – e.g. ↓pH in systemic acidosis
What does specific gravity indicate?
indicates amount of solute dissolved in urine – ↓ in diabetes insipidus
What does blood indicate?
indicates number of red blood cells in urine – ↑ in haematuria
What does protein indicate?
indicates level of protein in the urine – ↑ nephrotic syndrome
What does leukocyte esterase in the urine indicate?
enzyme produced by neutrophils (WCC in urine) – ↑ in UTI
What do nitrites in the urine indicate?
breakdown products caused by Gram -ve organisms – Gram -ve UTI e.g. Ecoli
What do Ketones in the urine indicate?
breakdown product of fatty acid metabolism – ↑ starvation / ↑DKA
What does glucose in the urine indicate?
↑ hyperglycaemia e.g. poorly controlled diabetes
What does bilirubin in the urine indicate?
Indicates ↑ conjugated bilirubin (water soluble) – ↑ biliary tract obstruction
What does urobilinogen in the urine indicate?
if raised indicates ↑ bilirubin turnover – ↑malaria / ↑haemolytic anaemia
