Urinalysis: Composition and Examination

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Questions and Answers

What is the normal average 24-hour urine volume in adults with normal fluid intake?

1.2-1.5L (correct)

0.5-1L

2-3L

3-5L

What is the term for urine output less than 500mL/day?

Polyuria

Oliguria (correct)

Anuria

Nocturia

What is the normal color of urine due to the presence of?

Bilirubin

Biliverdin

Urochrome (correct)

Hemoglobin

What can cause cloudiness in normal urine?

Epithelial cells, mucus, sperm, and prostatic fluid Signup and view all the answers

What is the term for urine output less than 100mL/day?

Anuria Signup and view all the answers

What is the term for excessive urination during the night?

Nocturia Signup and view all the answers

What is the normal appearance of urine in terms of transparency?

Clear or transparent Signup and view all the answers

What can cause abnormally colored urine?

Pathologic conditions, certain foods, and drugs Signup and view all the answers

What percentage of urine is composed of water?

95% Signup and view all the answers

What is the major nitrogenous end product of protein metabolism?

Urea Signup and view all the answers

What is the normal route of excretion for uric acid?

Urine Signup and view all the answers

What is the result of high protein diet or conditions associated with increased protein catabolism?

High urea excretion Signup and view all the answers

What is the function of the liver in protein metabolism?

Converting ammonia into urea Signup and view all the answers

What is the term for the combination of urate with sodium?

Monosodium urate Signup and view all the answers

What is the source of creatinine in the urine?

Muscle mass Signup and view all the answers

What is the significance of high concentrations of urinary constituents?

Pathology Signup and view all the answers

What is the purpose of collecting a first morning urine specimen?

Suitable for microscopic examination and routine urinalysis Signup and view all the answers

Why is sodium bicarbonate used in urine collection?

To interfere with other urine constituents Signup and view all the answers

What is the purpose of a postprandial urine specimen?

To measure the level of glucose in the urine Signup and view all the answers

What is the purpose of a midstream clean catch urine specimen?

Suitable for culture and sensitivity testing Signup and view all the answers

What is the purpose of a 24-hour urine specimen?

Used in various renal function tests Signup and view all the answers

What is the purpose of a catheter collection urine specimen?

Conducted when a patient is bedridden or cannot urinate independently Signup and view all the answers

What should you do before cleansing your genital area?

Wash your hands thoroughly with soap and water Signup and view all the answers

What is the purpose of a suprapubic aspiration urine specimen?

For bedridden patients that cannot be catheterized or a sterile specimen is required Signup and view all the answers

What should you do with the used towelettes?

Discard them in a trash receptacle Signup and view all the answers

What type of urine specimen is collected at any time during the examination?

Random urine specimen Signup and view all the answers

When should you catch the midstream of the urine flow in the collection container?

After urinating for several seconds into the toilet bowl Signup and view all the answers

What should you do with the specimen container after collecting the urine sample?

Tightly screw the cap on Signup and view all the answers

What should you do after collecting the urine sample?

Wash your hands thoroughly with soap and water Signup and view all the answers

What is the purpose of using a sterile cleansing towelette?

To cleanse your genital area Signup and view all the answers

Why should women squat over the toilet when collecting a midstream urine sample?

To separate and hold open the folds of the skin in the genital area Signup and view all the answers

What should be done with the specimen container after it is collected?

Promptly give it to the nurse or laboratory personnel Signup and view all the answers

What is the normal odor of urine?

Faint aromatic Signup and view all the answers

What is the purpose of measuring specific gravity of urine?

To evaluate the concentrating and excretory function of the kidney Signup and view all the answers

What is the normal range of specific gravity of urine?

1.005 – 1.030 Signup and view all the answers

What may cause increased urine specific gravity?

Dehydration Signup and view all the answers

What is the normal pH range of urine?

4.6 – 8.0 Signup and view all the answers

What may cause increased acidity in urine?

Diabetes, starvation, and a diet high in meat products Signup and view all the answers

Why must a urine sample be fresh?

To ensure accurate pH measurement Signup and view all the answers

What is the term for a fixed specific gravity of 1.010?

Isosthenuria Signup and view all the answers

Study Notes

Urine Composition

Urine is a complex aqueous mixture consisting of 95% water and 5% dissolved substances.
Nitrogenous wastes in urine: urea, uric acid, and creatinine.
Other normal solutes in urine: Na+, Cl-, K+, PO34-, SO42-, Ca2+, Mg2+, HCO3-.
Abnormally high concentrations of any urinary constituents may indicate pathology.

Urine Composition: Urea

Urea is a water-soluble compound, CO(NH2)2, that is the major nitrogenous end product of protein metabolism.
Breakdown of proteins by the body, during which amino groups are removed from amino acids and converted into ammonia, which is then converted into urea by the liver.
High urea excretion results from high protein diet or conditions associated with an increased protein catabolism (e.g., diabetes mellitus).

Urine Composition: Uric Acid

Uric acid is the end product of purine metabolism.
75% of uric acid is excreted in urine by the kidneys, while the remaining 25% is secreted into the gastrointestinal tract.
Uric acid exists mainly as urate in synovial fluid and plasma, and can combine with sodium to form monosodium urate crystals.

Urine Composition: Creatinine

Creatinine is a breakdown product of creatine and will be excreted by the kidneys in the urine at a constant rate, depending on muscle mass.
Creatine is a naturally occurring amino acid found in the muscle.

Collection and Preservation of Urine Sample

Type of urine specimens: first morning, random, postprandial, midstream clean catch, 24-hour, catheter, suprapubic aspiration, and pediatric.
Each type of urine specimen has its own specific purpose and collection method.

FEME Analysis

Urinalysis consists of physical observation, chemical analysis, and microscopic examination.
FEME Chemistry test uses dipstick method.
FEME Microscopic observation examines particles such as cells, bacteria, casts, and crystals.

Physical Observation

Physical properties of urine include: volume, color, transparency, odor, and specific gravity.
Normal urine volume: 1.2–1.5L.
Abnormalities in urine volume: oliguria, polyuria, anuria, and nocturia.
Normal urine color: pale yellow to deep amber.
Abnormalities in urine color: due to pathologic conditions, certain foods, and drugs.
Normal urine transparency: clear or transparent.
Abnormalities in urine transparency: due to epithelial cells, mucus, sperm, prostatic fluid, RBCs, WBCs, or bacteria.
Normal urine odor: faint aromatic odor.
Abnormalities in urine odor: due to certain metabolites, such as acetone, ammonia, and phenylketonuria.
Normal urine specific gravity: 1.005 – 1.030.
Abnormalities in urine specific gravity: due to dehydration, diabetes mellitus, proteinuria, overhydration, chronic renal diseases, and renal tubular damage.

FEME Chemical Observation

Chemical properties of urine include: pH, protein, glucose, ketone, blood, bilirubin, urobilinogen, nitrite, and leukocyte esterase.
Normal urine pH range: 4.6 – 8.0 (average 6.0).
Abnormalities in urine pH: due to diabetes, starvation, systemic acidosis, or a diet high in meat products and cranberries, and bacteria, urinary tract infection, or a diet high in citrus fruits and vegetables.

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Description

Learn about the composition of urine, urine sample collection and preservation, types of urine specimens, and FEME analysis including physical, chemical, and microscopic examination of urine.