Urine Composition and Volume Quiz
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Urine Composition and Volume Quiz

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Questions and Answers

Which factor does NOT influence urine volume?

  • Fluid intake
  • Variations in the secretion of ADH
  • Fluid loss from nonrenal sources
  • Exercise intensity (correct)

    • What is the typical range of urine volume voided by an adult each day?

  • 600-2000 mL (correct)
  • 300-900 mL
  • 1500-2500 mL
  • 1200-1500 mL

    • Which condition is associated with decreased urine output (oliguria)?

  • Diabetes mellitus (correct)
  • Chronic kidney disease
  • Hypertension
  • Gastroenteritis

    • What is the appropriate capacity for routine urinalysis containers?

    <p>50 mL</p> Signup and view all the answers

    What is the correct way to label a urine specimen container?

    <p>Labels must be attached to the container, not the lid</p> Signup and view all the answers

    What is the correct order of steps for the clean-catch urine collection procedure for men?

    <p>Wash hands, wash end of penis, void into the toilet, collect urine.</p> Signup and view all the answers

    Why is it important to touch only the outer surfaces of the container during the urine collection process?

    <p>To ensure the container stays sterile and prevents contamination.</p> Signup and view all the answers

    What method is used for obtaining a specimen through the abdomen into the bladder?

    <p>Suprapubic aspiration.</p> Signup and view all the answers

    When collecting pediatric specimens using plastic bags, what is the next step after enough urine has been collected?

    <p>Remove the bag and pour the specimen into a container.</p> Signup and view all the answers

    What is the recommended volume of urine to be collected during the clean-catch urine procedure?

    <p>30-100 mL</p> Signup and view all the answers

    What is a criterion that would lead to the rejection of a specimen?

    <p>Specimens contaminated with feces or toilet paper</p> Signup and view all the answers

    Which method is recommended for preserving specimens if testing cannot occur within two hours?

    <p>Refrigeration or use of chemical preservatives</p> Signup and view all the answers

    What effect does increased bacterial multiplication have on urine composition?

    <p>Decreases clarity</p> Signup and view all the answers

    Which of the following could lead to specimen rejection due to improper handling?

    <p>Specimens transported at room temperature for over 24 hours</p> Signup and view all the answers

    What change occurs in urine when it is not preserved properly?

    <p>Color modification or darkening</p> Signup and view all the answers

    What happens to glucose levels in urine if it is not preserved appropriately?

    <p>Decreases due to glycolysis and bacterial use</p> Signup and view all the answers

    Which of the following is NOT a method of preserving specimens?

    <p>Storing in a non-sterile container</p> Signup and view all the answers

    What is the primary cause of changes in urinalysis results if the sample is delayed beyond the recommended time frame?

    <p>Bacterial multiplication and growth</p> Signup and view all the answers

    What is a potential consequence of not emptying the bladder at the start of a 24-hour timed urine specimen collection?

    <p>It may falsely increase results.</p> Signup and view all the answers

    Which urine collection method typically provides the least contamination from epithelial cells and bacteria?

    <p>Clean-catch midstream specimen</p> Signup and view all the answers

    How should specimens be treated during the collection period for a 24-hour timed specimen?

    <p>They should be refrigerated.</p> Signup and view all the answers

    Which of the following is NOT a common error associated with timed urine collections?

    <p>Accurate transcription of measurements</p> Signup and view all the answers

    What is the primary benefit of using a concentrated urine sample in tests?

    <p>It prevents false-negatives.</p> Signup and view all the answers

    What is typically collected during a catheterized urine specimen procedure?

    <p>Bacterial cultures</p> Signup and view all the answers

    What type of urine specimen collection is ideal for quantitating protein and electrolytes?

    <p>24-hour timed specimen</p> Signup and view all the answers

    In a clean-catch urine collection, what is the purpose of discarding the first part of the urine stream?

    <p>To reduce contamination from the urethra.</p> Signup and view all the answers

    What is the maximum duration for which specimens should be refrigerated before analysis or culturing?

    <p>24 hours</p> Signup and view all the answers

    What is the primary reason specimens should be allowed to return to room temperature before chemical reagent strip testing?

    <p>To ensure optimal enzyme activity</p> Signup and view all the answers

    Which of the following is NOT a characteristic of an ideal urine preservative?

    <p>Enhances enzyme reactions</p> Signup and view all the answers

    What is a disadvantage associated with using boric acid as a urine preservative?

    <p>Precipitation of phosphates</p> Signup and view all the answers

    What type of specimen is primarily known as a spot specimen?

    <p>Random Specimen</p> Signup and view all the answers

    Which specimen type is best for urine pregnancy testing?

    <p>First Morning Specimen</p> Signup and view all the answers

    What should NOT be used if the urine level in a Gray C&S tube is below the minimum fill line?

    <p>Boric acid</p> Signup and view all the answers

    What is an advantage of refrigeration as a urine preservative?

    <p>Prevents metabolism of urine elements</p> Signup and view all the answers

    Study Notes

    Urine Composition

    • Sodium is found primarily in salt.
    • Potassium is combined with chloride and other salts.
    • Trace amounts of phosphate, ammonium and calcium are also present.
    • Phosphate combines with sodium to regulate blood pH (buffering).
    • Ammonium helps regulate blood and tissue fluid acidity.
    • Calcium combines with chloride sulfate and phosphate.

    Urine Volume

    • Normal urine volume is typically 600-2000 mL, with a common range of 1200-1500 mL.
    • Volume is affected by fluid intake, fluid loss from nonrenal sources, and variations in the secretion of antidiuretic hormone (ADH).

    Decreased Urine Volume

    • Oliguria is a decrease in urine output, below 2.5 L/day.
    • Oliguria can be associated with conditions like diabetes mellitus and diabetes insipidus.
    • Substances like diuretics, caffeine, and alcohol can suppress ADH secretion, artificially inducing oliguria.

    Diabetes Mellitus vs. Diabetes Insipidus

    • Urine analysis can be used to differentiate between these types of diabetes.

    Specimen Collection Containers

    • Urine must be collected in clean, dry, leak-proof containers.
    • Containers should be disposable, with screw-top lids to prevent leakage.
    • For routine urinalysis, wide mouth and wide bottom containers are preferred.
    • Clear material allows for color and clarity assessment.
    • Sterile containers are necessary for microbiology testing.

    Specimen Collection Labelling and Requisitions

    • Specimen labels should include patient name, healthcare number, and date & time of collection.
    • Labels must be attached to the container, not the lid.
    • A requisition with matching information must accompany the specimen.

    Specimen Rejection Criteria

    • Unlabeled containers.
    • Mismatched patient information on specimen label and requisition.
    • Specimens contaminated with feces or toilet paper.
    • Containers with contaminated exteriors or leakage.
    • Insufficient specimen quantity.
    • Improperly transported or > 24 hours old specimens.
    • Specimens that were not properly preserved.
    • Urine cultures collected in non-sterile containers.
    • Inappropriate collection for the required testing.
    • Laboratories should have written policies regarding specimen rejection.

    Specimen Handling

    • Specimen collection, handling, processing, and reporting should meet laboratory standards.
    • Ideal testing time for urinalysis is within 2 hours.
    • Refrigeration or preservative use is recommended for delayed testing.
    • Improper preservation can alter urine composition due to bacterial growth.

    Changes in Unpreserved Urine

    • Color: Modified or darkened due to oxidation or reduction of metabolites.
    • Clarity: Decreased due to bacterial growth and precipitation.
    • Odor: Increased due to bacterial breakdown of urea to ammonia.
    • pH: Increased due to urea breakdown and loss of CO2.
    • Glucose: Decreased due to glycolysis and bacterial utilization.
    • Ketones: Decreased due to volatilization and bacterial metabolism.
    • Bilirubin: Decreased due to exposure to light and photooxidation.
    • Urobilinogen: Decreased due to oxidation.
    • Nitrite: Increased due to nitrate-reducing bacteria multiplication.
    • RBCs, WBCs, casts: Decreased due to disintegration in alkaline urine.
    • Bacteria: Increased due to multiplication.
    • Trichomonas: Decreased due to loss of motility and death.

    Urine Preservatives

    • Refrigeration at 2-8°C is the most common preservation method for up to 24 hours.
    • Specimens should be allowed to return to room temperature before reagent strip testing.
    • Chemical preservatives can be used for transport if refrigeration is unavailable.
    • The ideal preservative should be bactericidal, inhibit urease, preserve formed elements, and not interfere with chemical tests.
    • The choice of preservative should depend on the specific test ordered.

    Types of Urine Specimens

    • Random
    • First Morning
    • 24-hour (or timed)
    • Catheterized
    • Midstream Clean-Catch
    • Suprapubic Aspiration
    • Pediatric

    Random Specimen

    • Most common type of specimen.
    • Collected at any time.
    • Suitable for routine testing (physical, chemical, microscopic).

    First Morning Specimen

    • More concentrated than random urines.
    • Recommended for nitrite, protein, and microscopic examination.
    • Preferable for urine pregnancy testing to avoid false negatives.
    • Helpful for evaluating orthostatic proteinuria.
    • May have deteriorated casts.
    • Bacteria can impact glucose analysis (decreased glucose).

    24-Hour or Timed Specimen

    • Collect all voidings over a specific period (2, 12, or 24 hours).
    • Produces quantitative results for protein, creatinine, and electrolytes.
    • Specimens should be refrigerated during collection and mixed well before analysis.
    • Preservatives may be required.

    Common Errors with Timed Urines

    • Loss of urine specimens.
    • Inclusion of two first morning specimens.
    • Inaccurate total volume measurement.
    • Inadequate or incorrect preservative use.
    • Transcription errors.

    Catheterized Specimen

    • Collected under sterile conditions.
    • A hollow tube is inserted through the urethra into the bladder.
    • Commonly requested for bacterial cultures.

    Midstream Clean-Catch Specimen

    • Patient cleanses the genital area with wipes before mid-urination collection.
    • Reduces contamination with epithelial cells and bacteria.

    Clean-Catch Urine Collection Procedures for Women

    1. Wash hands thoroughly.
    2. Remove container lid without touching the inside.
    3. Squat over the toilet.
    4. Separate the folds of skin around the urinary opening.
    5. Cleanse from front to back with wipes.
    6. Void into the toilet for a few seconds.
    7. Hold the container in the urine stream.
    8. Finish voiding into the toilet.
    9. Secure the lid without touching the inside.
    10. Clean the exterior with an antiseptic wipe.

    Clean-Catch Urine Collection Procedures for Men

    1. Wash hands thoroughly.
    2. Remove container lid without touching the inside.
    3. Wash the end of the penis with a wipe, starting at the urethral opening and working away in a circular motion (retract foreskin if present).
    4. Void into the toilet for a few seconds.
    5. Hold the container in the urine stream.
    6. Finish voiding into the toilet.
    7. Secure the lid without touching the inside.
    8. Clean the exterior with an antiseptic wipe.

    Suprapubic Aspiration

    • Needle is inserted through the abdomen into the bladder.
    • Provides a contamination-free sample for bacterial culture and cytologic examination.

    Pediatric Specimens

    • Collected using soft, clear plastic bags attached to the infant's genital area.
    • Once sufficient urine is collected, the bag is removed and the specimen poured into a container.
    • Catheterization or suprapubic aspiration can also be used.

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    Introduction to Urinalysis PDF

    Description

    Test your knowledge on the composition and volume of urine in this quiz. Explore concepts like normal urine volume, the effects of various substances on urine output, and the differences between diabetes mellitus and diabetes insipidus. Challenge yourself and deepen your understanding of renal physiology.

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