Urine Testing. Testing Urine Unit 18:11 Urinalysis Examination of urine Physical Chemical...
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Transcript of Urine Testing. Testing Urine Unit 18:11 Urinalysis Examination of urine Physical Chemical...
Urine Testing
Testing Urine
Unit 18:11
Urinalysis
Examination of urine Physical Chemical Microscopic
Physical Testing of Urine
Observing color, transparency & specific gravity
Color
Normal: shade of yellow Pale: dilute Dark yellow, orange: concentrated Cloudy red: hematuria Clear-red: hemoglobin Yellow or beer-brown: bilirubin
(bilirubinuria)
Transparency Normal: clear Cloudy: pus,
mucus Milky: fats
Specific Gravity
Normal: 1.005 to 1.030 Increased: dehydration, diabetes
mellitus Decreased: kidney disease,
diuretic, increased fluid intake
Odor
Normal: Faintly aromatic Ammonia: old sample Foul: infection Sweet: DM, ketones
Chemical Testing pH Protein Glucose Ketones
Bilirubin Urobilinogen Blood
Microscopic Testing Examine formed
elements in urine Cells Casts Crystals Amorphous debris
Which urine is best? Fresh, warm urine Within 1 hour of
collection Maybe
refrigerated if needed
Precautions Must use standard
precautions Gloves, possibly
mask, eyewear Discard urine in a
toilet Dispose of
specimen in infectious waste bag
Using Reagent Strips to Test Urine
Unit 18:12
Reagent Strips Firm plastic strip
with chemical reactants attached to the strip
Color change indicates presence of substance & amount of substance
Storage
Sensitive to light, heat, moisture Store in dry, cool, dark area Keep bottle closed
Precautions
Don’t touch chemical reactant pads
May lead to inaccurate results or injure the skin
pH
Measure of acidity or alkalinity of urine
Normal: 5.5 to 8.0 Affected by:
Diet Medications Kidney disease Starvation
Protein
Normal: none Proteinuria may indicate kidney
disease
Glucose
Normal: none May indicate Diabetes mellitus
Ketones
End product of fat metabolism Normal = none May indicate:
Diabetes mellitus Fasting, dieting High fat diet
Blood Normal = none May indicate:
Injury Infection Menstruation Kidney disease
Bilirubin Break down
product of hemoglobin
Normal = none May indicate:
Liver disease
Urobilinogen
Bilirubin converted by intestinal bacteria
Normal: small amounts May indicate:
Heart, spleen, liver or hemolytic disease
Spectrophotometers Automated strip
analyzer More accurate
than human eye
Refrigerated samples
Must be returned to room temperature
Time
Follow exact time for each chemical reaction
Measuring Specific Gravity
Unit 18:13
Specific Gravity
Density of a substance compared to the density of water
Normal: 1.005 to 1.030
Urinometer Urine in a cylinder
and calibrated float is placed in urine with a spinning motion
Urine collects at curved line, meniscus
Read of lower part of meniscus
Refractometer One drop of urine
placed on device & look through an eyepiece
Calibrate with water
Preparing Urine for Microscopic Examination
Unit 18:4
Urine Sediment
Solid materials suspended in urine
What urine?
Fresh, early morning first voided specimen preferable
Examine immediately Some elements disintegrate
Centrifuge Spin ~10-15 cc of
urine Solid materials
settle at the bottom
Preparation
Clear urine on top is poured off Leave behind 1 cc in bottom
Examine immediately
Drying occurs quickly & can distort substances
lpf and hpf
Low power field and high power field
Indicate amount seen in a field
RBCs Normal = none May indicate:
Kidney disease Bleeding in
urinary tract Menstruation
WBCs Normal = small
numbers May indicate:
infection
Bacteria Normal: none to
small amount Large amount
indicates infection
Other infectious agents Fungi, yeasts Parasites
Casts Formed in kidney
tubules during kidney damage
Normal = none
Crystals Dependent on
urine pH