Understanding the Urinalysis

Understanding the Urinalysis

Paul Cousineau NPYouville Hospital and Rehab Center

Paul Cousineau NPYouville Hospital and Rehab Center

The UrinalysisThe Urinalysis

The Urinalysis is a screening test most commonly requested when what is suspected?

StrokeGlucosuria

Heart AttackUrinary tract infection

The Urinalysis is a screening test most commonly requested when what is suspected?

StrokeGlucosuria

Heart AttackUrinary tract infection

Collecting the Urine Specimen

Collecting the Urine Specimen

Cultural Attitudes. Privacy. Wear gloves. Provide the appropriate

container. Provide assistance as needed. Offer hand washing.

Cultural Attitudes. Privacy. Wear gloves. Provide the appropriate

container. Provide assistance as needed. Offer hand washing.

Collecting Urine from the Catheter

Collecting Urine from the Catheter

Never collect from the drainage bag Find the port at the junction of the

catheter and the drainage bag. Cleanse with alcohol and with a

sterile needle, draw up the required sample of urine.

Finally, withdraw the needle and cleanse the port.

Never collect from the drainage bag Find the port at the junction of the

catheter and the drainage bag. Cleanse with alcohol and with a

sterile needle, draw up the required sample of urine.

Finally, withdraw the needle and cleanse the port.

Observe the Urine specimen

Observe the Urine specimen

Color: In its normal state, urine should be straw coloured

Odor: Freshly voided urine has practically no smell.

Testing: Reagent strips

Color: In its normal state, urine should be straw coloured

Odor: Freshly voided urine has practically no smell.

Testing: Reagent strips

Reagent Strip TestingReagent Strip Testing

Quick look. Time is everything… watch for

changes according to the times recommended by the manufacturer of the product.

Lay the strip on a flat surface to avoid contaminating adjacent testing markers.

Quick look. Time is everything… watch for

changes according to the times recommended by the manufacturer of the product.

Lay the strip on a flat surface to avoid contaminating adjacent testing markers.

The Reagent Strip.The Reagent Strip.

Specific GravitySpecific Gravity

Specific Gravity refers to the weight of an equal volume of distilled water and depends on the weight of the solute particles per volume of urine.

Normal Specific Gravity: 1.005~1.030 High SP can indicate dehydration Low SP can indicate overhydration, or the

kidney’s inability to concentrate urine.

Specific Gravity refers to the weight of an equal volume of distilled water and depends on the weight of the solute particles per volume of urine.

Normal Specific Gravity: 1.005~1.030 High SP can indicate dehydration Low SP can indicate overhydration, or the

kidney’s inability to concentrate urine.

pHpH Body’s ability to maintain normal acid-

base balance is reflected in the urine pH.

Normal pH: ~7 Low pH: acid

Gout, fever, predisposition to uric acid calculi (kidney stones)

High pH: alkaline suggests urinary tract infection,

vegetarian diet, alkalosis

Body’s ability to maintain normal acid-base balance is reflected in the urine pH.

Normal pH: ~7 Low pH: acid

Gout, fever, predisposition to uric acid calculi (kidney stones)

High pH: alkaline suggests urinary tract infection,

vegetarian diet, alkalosis

Leukocyte esteraseLeukocyte esterase

The leukocyte esterase (LE) test detects esterase, an enzyme released by white blood cells.

Positive test results are clinically significant for infection.

The leukocyte esterase (LE) test detects esterase, an enzyme released by white blood cells.

Positive test results are clinically significant for infection.

NitritesNitrites

Bacteria that cause a urinary tract infection, UTI, make an enzyme that changes urinary nitrates to nitrites.

Nitrites in urine show a UTI is present.

Bacteria that cause a urinary tract infection, UTI, make an enzyme that changes urinary nitrates to nitrites.

Nitrites in urine show a UTI is present.

ProteinProtein

Protein is normally not found in the urine.

Fever, hard exercise, pregnancy, and some diseases, especially kidney disease, may cause protein to be in the urine.

Protein is normally not found in the urine.

Fever, hard exercise, pregnancy, and some diseases, especially kidney disease, may cause protein to be in the urine.

GlucoseGlucose

Normally there is very little or no glucose in urine.

When the blood sugar level is very high, as in uncontrolled diabetes, the sugar spills over into the urine.

Glucose can also be found in urine when the kidneys are damaged or diseased.

Normally there is very little or no glucose in urine.

When the blood sugar level is very high, as in uncontrolled diabetes, the sugar spills over into the urine.

Glucose can also be found in urine when the kidneys are damaged or diseased.

KetonesKetones

When fat is broken down for energy, the body makes substances called ketones.

Ketones are subsequently passed in the urine.

High levels of ketones in the urine may mean a very serious condition, diabetic ketoacidosis, is present.

When fat is broken down for energy, the body makes substances called ketones.

Ketones are subsequently passed in the urine.

High levels of ketones in the urine may mean a very serious condition, diabetic ketoacidosis, is present.

UrobilinogenUrobilinogen

This is a substance formed by the breakdown of bilirubin.

It is also passed from the body in stool. Only small amounts of urobilinogen are

normally found in urine. Urobilinogen in urine can be a sign of

liver disease that the flow of bile from the gallbladder is blocked.

This is a substance formed by the breakdown of bilirubin.

It is also passed from the body in stool. Only small amounts of urobilinogen are

normally found in urine. Urobilinogen in urine can be a sign of

liver disease that the flow of bile from the gallbladder is blocked.

BloodBlood

Blood is not a normal finding in urine. Red blood cells in the urine may be

caused by kidney or bladder injury, kidney stones, a urinary tract infection (UTI), inflammation of the kidneys, a kidney or bladder tumor, or systemic autoimmune disease.

Blood is not a normal finding in urine. Red blood cells in the urine may be

caused by kidney or bladder injury, kidney stones, a urinary tract infection (UTI), inflammation of the kidneys, a kidney or bladder tumor, or systemic autoimmune disease.

Sediment ExaminationSediment Examination

Promptly send to the lab for identification of: White Blood cells Red Blood cells Epithelial cells Casts Crystals

Promptly send to the lab for identification of: White Blood cells Red Blood cells Epithelial cells Casts Crystals

The Urine Culture and Sensitivity

The Urine Culture and Sensitivity

Send to the laboratory for

timely management.

Send to the laboratory for

timely management.

Questions ?

Questions ?

Thank you for your

attention, participation

and hard work.

Thank you for your

attention, participation

and hard work.