Introduction to Urinalysis Chapter 3 PDF

6/20/2024 Introduction to Urinalysis Chapter 3 1 Preamble ▪ PowerPoints are a general overview and are provided to help students take notes over the video lecture ONLY. – PowerPoints DO NOT cover the details needed for the Unit exam ▪ Each student is...

6/20/2024 Introduction to Urinalysis Chapter 3 1 Preamble ▪ PowerPoints are a general overview and are provided to help students take notes over the video lecture ONLY. – PowerPoints DO NOT cover the details needed for the Unit exam ▪ Each student is responsible for READING the TEXTBOOK for details to answer the UNIT OBJECTIVES ▪ Unit Objectives are your study guide (not this PowerPoint) ▪ Test questions cover the details of UNIT OBJECTIVES found only in your Textbook! 2 1  6/20/2024 History and Importance ▪ The beginning of laboratory medicine – Cavemen drawings and Egyptian hieroglyphics ▪ Color, turbidity, odor, volume, viscosity, sweetness – Fifth century BC, Hippocrates wrote uroscopy book – AD 1140, color charts – 1694, albuminuria determination by “boiling” – Charlatans/“pisse prophets” ▪ First medical licensure laws – 17th century, invention of the microscope ▪ Evaluation of sediment – Part of a routine physical in 1827 3 History and Importance (continued_1) ▪ Readily available and easily collected specimen ▪ Urine contains information, which can be obtained by inexpensive laboratory tests, to assess many metabolic functions ▪ CLSI Urinalysis definition: “the testing of urine with procedures commonly performed in an expeditious, reliable, safe, and cost-effective manner” ▪ Reasons to perform – Aid disease diagnosis, screen for asymptomatic diseases, monitor disease progress and therapy effectiveness 4 2  6/20/2024 Urine Formation ▪ Ultrafiltrate of plasma ▪ Kidneys convert approximately 170,000 mL of filtered plasma ▪ Average daily urine output of 1200 mL 5 Urine Composition Major organic solute is Solute variations: diet, urea (protein, amino acid Normal 95% water, 5% activity, metabolism, and breakdown); makes up solutes endocrine functions approximately one half of the dissolved solids May also contain cells, Creatinine, urea, sodium, casts, crystals, mucus, Inorganic: chloride, and bacteria and chloride are higher in sodium, and potassium urine Increases indicative of disease 6 3  6/20/2024 Urine Volume Determined by body’s state of hydration Influenced by fluid intake, nonrenal fluid loss, antidiuretic hormone (ADH) variations, excretion of large amounts of dissolved solids (e.g., glucose) Usual daily volume = 1200 to 1500 mL Normal range = 600 to 2000 mL 7 Urine Volume (continued) Oliguria: a decrease in urine output 10 times the pre-massage count 31 Prostatitis Specimen (continued_2) Stanmey-Meares test includes examination of four urine specimens First urine specimen is voided bladder (VB1) and represents the urethral specimen Second urine specimen, voided bladder 2 (VB2)represents the bladder specimen Third specimen is the expressed prostatic specimen (EPS) Fourth specimen is voided bladder (VB3) collected after EPS 32 16  6/20/2024 Prostatitis Specimen (continued_3) 10 mL of urine is used for both the first and second specimens All four specimens are sent for culture After centrifugation the sediment is examined for WBC/aggregates and macrophages Oval fat bodies Bacteria Fungal hypha Urethral infection or inflammation is tested for by VB1 Urinary bladder infection is tested for by VB2 Prostatic secretions are cultured and examined for WBC 10-20 WBC is considered abnormal 33 Pediatric Specimens Soft, clear, plastic bags, with hypoallergenic tape applied to genital area Diaper is placed over the collection bag Check the bag every 15 minutes Remove bag after specimen has been collected Label the bag or collection container 34 17  6/20/2024 Drug Specimen Collection ▪ Proper collection, labeling, and handling must be documented ▪ Chain of custody: documentation from the time of specimen collection until the time of receipt of laboratory results – Free of substitution, adulteration, or dilution ▪ Standardized form always accompanies specimen ▪ Specimen must withstand legal scrutiny 35 Drug Specimen Collection (continued_1) ▪ Points to consider – Photo ID of urine donor or ID by employer – No unauthorized access to specimen ▪ Witnessed versus unwitnessed collection – Determined by test orderer – Both specimens must be handed immediately to collector 36 18  6/20/2024 Drug Specimen Collection (continued_2) ▪ Adulteration tests – Temperature taken within 4 minutes must be 32.5°C to 37.7°C – Report temperatures outside of range immediately – Collect another specimen ASAP – Inspect urine color for anything unusual ▪ Follow laboratory instructions for labeling, packaging, and transport 37 Postamble ▪ READ the TEXTBOOK for the details to answer the UNIT OBJECTIVES. ▪ USE THE UNIT OBJECTIVES AS A STUDY GUIDE ▪ All test questions come from detailed material found in the TEXTBOOK (Not this PowerPoint) and relate back to the Unit Objectives 38 19