Urinalysis Basics

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Questions and Answers

What effect can dehydration have on the urinary system?

It can lead to increased urine production.

It does not affect urinary excretion.

It enhances the absorption of nutrients in the kidneys.

It may contribute to urinary tract infections, stones, and kidney failure. (correct)

Which of the following foods can cause a change in the odor of urine?

Carrots

Bananas

Asparagus (correct)

Blueberries

What is the significance of finding bilirubin in urine?

It may indicate liver problems and could appear before jaundice is visible. (correct)

It suggests normal liver function.

It always signifies a urinary infection.

It is an indicator of dehydration.

What might a dark, smoky color in urine indicate?

Dehydration or hematuria. Signup and view all the answers

Which drug class is known to potentially induce hematuria?

Anticoagulants Signup and view all the answers

How do steroids affect urine characteristics?

They can lead to increased retention of water. Signup and view all the answers

Which condition does NOT typically lead to increased daytime voiding frequency?

Severe dehydration Signup and view all the answers

What is the correct classification of hyaline casts in urinalysis?

Occasionally found in normal urine. Signup and view all the answers

What dietary habits are associated with stone formation?

High dairy or protein intake Signup and view all the answers

What urine color may indicate the presence of phenazopyridine or rifampin?

Orange-red to orange-brown Signup and view all the answers

What condition could result in colorless urine?

Excess fluid intake Signup and view all the answers

What does a urinary pH greater than 8.0 typically indicate?

Urinary tract infection (UTI) Signup and view all the answers

What osmolality result would suggest a tubular dysfunction in urine concentration?

< 50 Signup and view all the answers

What does the presence of ketones in urine typically indicate?

Altered carbohydrate and fat metabolism Signup and view all the answers

What can persistent proteinuria signal?

Acute or chronic kidney disease Signup and view all the answers

What is indicated by a low RBC count in urine (0-4)?

Normal condition Signup and view all the answers

What might an ammonia-like odor in urine suggest?

Dehydration or bacterial growth Signup and view all the answers

What does a bacteria count greater than $10^5$ typically indicate?

Urinary tract infection (UTI) Signup and view all the answers

What condition could lead to a high glucose level in urine?

Diabetes with low renal threshold for glucose Signup and view all the answers

What is the most common pathogen responsible for urinary tract infections (UTIs)?

E.coli Signup and view all the answers

Which of the following symptoms is most likely associated with pyelonephritis?

CVA tenderness Signup and view all the answers

What distinguishes urethritis from cystitis regarding symptoms?

Discharge from the urethra Signup and view all the answers

Which imaging technique is considered safer than a CT scan for assessing urinary tract conditions?

Ultrasound Signup and view all the answers

In cases of pyelonephritis, which laboratory test result is expected?

Pyuria Signup and view all the answers

When treating urinary tract infections, what is the primary goal of interprofessional care?

To switch to oral medications when possible Signup and view all the answers

Which of the following is NOT a common systemic symptom of a urinary tract infection?

Discharge Signup and view all the answers

What is a common antibiotic used for treating urinary tract infections until culture results are available?

Ciprofloxacin Signup and view all the answers

Which factor does NOT contribute to the classification of urinary tract infections?

Patient's age Signup and view all the answers

Which treatment approach is advised for patients diagnosed with cystitis?

Antibiotic treatment based on culture sensitivity Signup and view all the answers

Which of the following is NOT a risk factor for Benign Prostatic Hyperplasia?

Excessive caffeine consumption Signup and view all the answers

What is the primary manifestation that often leads individuals with Benign Prostatic Hyperplasia to seek medical attention?

Nocturia Signup and view all the answers

Which of the following diagnostic tests is used to assess prostate size for Benign Prostatic Hyperplasia?

Digital rectal exam (DRE) Signup and view all the answers

Which treatment option is primarily used to remove prostate tissue in patients with severe Benign Prostatic Hyperplasia?

Transurethral Resection of Prostate (TURP) Signup and view all the answers

Which of the following is a common manifestation associated with advanced Kidney Cancer?

Painless hematuria Signup and view all the answers

What is the most common type of cancer found in the urinary system?

Bladder Cancer Signup and view all the answers

Which of the following symptom is NOT typically associated with a lower urinary tract infection (UTI)?

Nausea Signup and view all the answers

What is the primary purpose of performing a urine culture and sensitivity test in diagnosing a urinary tract infection?

To determine the bacteria's susceptibility to antibiotics Signup and view all the answers

Which factor is a common cause of acute poststreptococcal glomerulonephritis?

Strep throat infection Signup and view all the answers

Which laboratory finding is typically NOT observed in the early stages of glomerulonephritis?

Hypertension Signup and view all the answers

What is a potential consequence of untreated obstructive disorders in the urinary tract?

Dilation of structures above the obstruction Signup and view all the answers

Which of the following is NOT a recommended dietary adjustment for managing glomerulonephritis?

Increased potassium Signup and view all the answers

What is the initial treatment approach for a urinary tract infection?

Begin empiric therapy Signup and view all the answers

Which symptom is commonly associated with late-stage glomerulonephritis?

Oliguria Signup and view all the answers

What is a key component of patient teaching for those being prescribed Pyridium?

Urine may turn orange/red Signup and view all the answers

What is the third leading cause of end-stage renal disease?

Chronic glomerulonephritis Signup and view all the answers

Study Notes

### Urinalysis

Urinalysis is a general exam of urine to determine baseline information and possible diagnosis.
A clean catch (voided) or catheter sample is required for testing.
The presence of bilirubin in the urine could indicate liver problems.
Casts in the urine could indicate molds in the renal tubules, which may contain protein, WBCs, RBCs, or bacteria.
Cloudy fresh urine may suggest a Urinary Tract Infection (UTI).
Yellow to brown colored urine might indicate excess bilirubin or medication intake.
Hematuria is indicated by a dark, smoky colored urine sample.
Colorless urine may indicate excess fluid intake, kidney disease, or diabetes insipidus.
Bacteria counts greater than 10^5 in the urine culture could indicate a UTI.
Glycosuria, or the presence of glucose in the urine, could point to diabetes, a low renal threshold for glucose, or pituitary problems.
Ketones in the urine indicate altered carbohydrate and fat metabolism in diabetes and starvation.
An ammonia-like smell of the urine may indicate the urine has been allowed to stand.
An unpleasant odor may be caused by a UTI.

Urinary Tract Infection (UTI)

UTIs can be either upper (kidney/ureters) or lower (bladder/urethra), and infections can spread upwards from the bladder.
E. coli is the most common pathogen responsible for UTIs, representing 75% of cases.
Pyelonephritis is a common cause of UTIs (inflammation of the kidneys).
Pyelonephritis is generally diagnosed with a CT or urogram and labs: CBC, CMP/BMP, Urine culture, blood cultures, and renal function studies.
Common UTI treatments include antibiotics, such as ampicillin, fluoroquinolones (ciprofloxacin, levofloxacin), and vancomycin, which should be administered via IV for a longer course, if needed.
If possible, the treatment goal is to help patients switch from IV to PO antibiotics.
Important patient education should include finishing all antibiotics, voiding regularly, increasing fluid intake, and potentially referring to a kidney specialist.

Glomerulonephritis

This inflammatory condition can cause changes in other parts of the kidney.
It usually affects kidneys bilaterally.
Can be acute or chronic, and is the third leading cause of end stage renal disease (ESRD).
Acute Poststreptococcal Glomerulonephritis (APSGN) commonly develops within 1-2 weeks following strep throat, mostly seen in children aged 5-7 and adults older than 60.
APSGN causes the body to produce antibodies to strep antigen-complexes, which deposit in the glomeruli and can cause scarring and damage.
Caused by infections, immune disorders, vasculitis, and comorbid conditions that scar the kidneys.
Early symptoms include hematuria, proteinuria, azotemia, an increase in urine specific gravity, increased ESR, oliguria, and abdominal or flank pain.
Later symptoms can include edema, hypertension, kidney failure, and pain in the abdomen/flank.
Diagnostics include a H&P, ASO titers, BUN/creatinine, renal biopsy, urinalysis for protein and RBC casts, and urine microscopy for erythrocyte casts.
Treatment involves antibiotics for infection, sodium restriction for edema, medications to manage hypertension, possible steroids, and a special diet that is low in protein, sodium, fluids, and potentially potassium.

Obstructive Disorders

Obstructive urinary conditions can be anatomical or functional and can impede the flow of urine, affecting the system above the level of obstruction.
Severity depends on the location, duration, amount of pressure or dilation, the presence of urinary stasis or infection, and can potentially require a nephrostomy tube.
Nursing care should include monitoring I/O, observing for bleeding or infection, pain management, and patient teaching regarding symptoms, infection, when to call, diet, repeat testing, and fluids.

Benign Prostatic Hyperplasia (BPH)

The prostate starts to increase in size.
Risk factors include age (men over 50), obesity/sedentary lifestyle, alcohol intake, erectile dysfunction, smoking, and diabetes.
Manifestations include nocturia, frequency, urgency, dysuria, bladder pressure, fullness, retention, dribbling, decreased force of stream, hesitancy during urination, and recurring UTIs due to retention.
Diagnostics include a digital rectal exam (DRE) and labs: PSA, urinalysis, C&S, CBC/CMP, and urodynamics to check the flow of urine.
Treatment should address lifestyle changes, medication options (alpha-blockers, 5-alpha reductase inhibitors, tadalafil), and possible procedures like ablation, thermotherapy, laser prostatectomy, or TURP (Transurethral Resection of Prostate).

Kidney Cancer

Renal cell carcinoma (adenocarcinoma) is more common in women (2x) than men, generally developing in adults between 50-70 years old.
Risk factors include smoking, family history, obesity, HTN, exposure to asbestos, cadmium, and gasoline.
Early onset is often asymptomatic.
Painless hematuria is a common symptom, and almost one-third of patients may have metastasis by the time of diagnosis.
Compression of structures may cause flank pain, along with other symptoms like weight loss, pain/mass in the flank or abdomen, fever, HTN, and anemia.
Diagnosis is made via CT, U/S, MRI, renal biopsy, and angiography.
Treatment is often resistant to chemo and radiation.
Options include radical nephrectomy, immunotherapy (alpha-interferon, interleukin-2, Opdivo), and kinase inhibitors (targeted therapy).

Bladder Cancer

The most common cancer of the urinary system, typically diagnosed in older adults.

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Description

Explore the fundamentals of urinalysis in this quiz. Learn about the significance of various components found in urine, including bilirubin, casts, and glucose. This quiz will help you understand how these factors can indicate different health conditions.