Urinalysis PDF

Urine specimen - Unacceptable situations include: Specimens in unlabeled containers - Urine is a biohazardous substance that Nonm...

Urine specimen - Unacceptable situations include: Specimens in unlabeled containers - Urine is a biohazardous substance that Nonmatching labels and requisition forms requires the observance of Standard Specimens contaminated with feces or Precautions. Gloves should be worn at all toiled paper times when in contact with the specimen. Containers with contaminated exteriors Specimen Container Specimens of insufficient quantify - Specimens must be collected in clean, dry, Specimens that have been improperly leakproof containers and should have a wide transported mouth to facilitate collections from female Specimen handling patients and a wide, flat bottom to prevent, overturning. - The fact that a urine specimen is so readily - Containers should be made of a clear available and easily collected often leads to material to allow for determination of color laxity in the treatment of the specimens after and clarity. its collection. Following collection, - The recommended capacity of the container specimens should be delivered to the is 50ml, which allows 12ml of specimen laboratory promptly and tested within 2 needed for microscopic analysis, additional hours and should be refrigerated or have an specimen to be mixed by swirling the appropriate chemical preservative added. container. Specimen preservation - Disposable containers are recommended because they eliminate the chance of - Urine specimens must be preserved at 2-8 contamination due to improper washing. degrees Celsius, which decreases bacterial growth and metabolism. If the urine is to be Specimen Labeling cultured, it should be refrigerated during - Labels must be attached to the container, transit and held refrigerated until cultured up not to the lid, and should not become to 24 hours. The specimen must return to detached if the container is refrigerated or room temperature before chemical testing frozen. by reagent strips. - All specimen labels must contain: Types of Specimens Patients name Patients’ identification number - To obtain a specimen that is representative Date and time of collection of a patient’s metabolic state, regulation of Patients age certain aspects of specimen collection is often necessary Physicians name - Special condition may include: Requisition form Time, length, and method of collection, and The patient’s dietary and medicinal intake - Must accompany specimens delivered to the laboratory. The information on the form Random specimen must match the information on the specimen label. Additional information on - Is the most commonly received specimen the form can include: because of its ease of collection and Method of collection/type of specimen convenience for the patient. It may be collected at any time, but the actual time of Possible interfering medications voiding should be recorded on the container Patients’ clinical information - The random specimen is useful for routine - The time the specimen is received in the screening tests to detect obvious laboratory should be recorded on the form. abnormalities. However, it may show Improperly labeled and collected erroneous results resulting from dietary specimens should be rejected, and intake or physical activity just before appropriate personnel should be notified to collections. collect a new specimen First Morning Specimen - If a specimen is collected in two containers, the contents of the containers should be - Or 8-hour specimen, is the ideal screening combined and thoroughly mixed before specimen. It is also essential for preventing aliquoting. false-negative pregnancy tests and for evaluating orthostatic proteinuria. The first Catheterized specimen morning specimen is a concentrated - This specimen is collected under sterile specimen, thereby assuring detection of conditions by passing a catheter through the chemicals and formed elements that may urethra into the bladder. The most not be present in a dilute random specimen. commonly requested test on a catheterized The patient should be instructed to collect specimen is a bacterial culture. the specimen immediately on arising and to deliver it to the laboratory within 2 hours. Midstream clean-catch specimen Fasting specimen (Second Morning) - As an alternative to the catheterized specimen, the midstream clean-catch - A fasting specimen differs from a first specimen provides a safer less traumatic morning specimen by being the second method for obtaining urine for bacterial voided specimen after period of fasting. culture and routine urinalysis. - This specimen will not contain any - Patients must be provided with appropriate metabolites from food ingested before the cleansing materials, a sterile container, and beginning of the fasting period. It is instruction for cleansing and voiding. recommended for glucose monitoring. Instruct patients to wash their hands before 2-hour postprandial specimen beginning the collection. Male patients should clean the glans, which begins at the - The patient is instructed to void shortly urethra, and withdraw the foreskin, if before consuming a routine meal and to necessary. collect a specimen 2 hours after eating. The - Female patients should separate the labia specimen is tested for glucose, and the and clean the urinary meatus and results are used primarily for monitoring surrounding area. When cleansing is insulin therapy in persons with diabetes complete, patients are to void first into the mellitus. toilet, then collect and adequate amount of Glucose Tolerance Specimen urine in the sterile container, and finish voiding into the toilet. - Glucose tolerance specimens are sometimes collected to correspond with the Suprapubic Aspiration blood samples drawn during a (GTT) as an - Occasionally urine may be collected by aid to interpreting the patient’s ability to external introduction of a needle through the metabolize a measured amount of glucose abdomen intro the bladder. Because the and are collated with the renal threshold for bladder is sterile under normal conditions, glucose. suprapubic aspiration provides sample for 24-hour (timed) specimen bacterial culture that is completely free of extraneous contamination. - To obtain an accurate timed specimen, the patient must begin and end the collection Prostatitis specimen period until an empty bladder. Addition of - The three-glass collection procedure is used urine formed before the start of the to determine prostatic infection. Instead of collection period or failure to include urine discarding the first urine passed, it is produced at the end of the collection period collected in a sterile container. Next, the will produce inaccurate results. midstream portion is collected in another - On its arrival in the lab, a 24-hour specimen sterile container. The prostate is then must be thoroughly mixed, and the volume massaged so that prostate fluid will be accurately measured and recorded.  passed with the remaining urine into a third - Is used to test for simple carbohydrates. It sterile container identifies reducing sugars, which have free ketone or aldehyde functional groups. Pediatric Specimen Benedict’s quatitative reagent contains - Collection of pediatric specimens can potassium thiocyanate and is used to present a challenged. Soft, clear plastic determine how much reducing sugar is bags with hypoallergenic skin adhesive to present. attach to the genital area of both boys and - Benedicts solution is a deep blue alkalie girls are available for collecting routine solution used to test for the presence of the specimens. aldehyde fuctional group, - CHO. One liter of benedicts solution can be prepared form Drug Specimen Collection 100 g of anhydrous sodium carbonate, 173 g - Urine specimen collection is the most of sodium citrate and 17. 3 g of copper (II) vulnerable part of a drug-testing program. sulfate pentahydrate. Correct collection procedures and Blue-sugar – absent documentation are necessary to ensure that Green – 0.5% sugar the results are those of the specific Yellow – 1% sugar individual submitting the specimen. For Orange – 1.5% sugar urine specimens to withstand legal scrutiny, Brich red – 2% sugar it is necessary to prove that no tampering of Urine Albumin Test the specimen occurred, such as substitution, adulteration, or dilutions. - Checks the urine for a protein called albumin. Albumin is normally found in the Urine Glucose Test blood and filtered by the kidneys. It is a - Measures the level of glucose, or sugar, in protein your body uses for tissue growth and the urine. It is less invasive than a blood repair. glucose test, but it also tends to be less - Ideally, waste products end up in the urine accurate. It is often performed to check for while albumin and other protein stay in the diabetes and may also be done to check for blood vessels. If albumin shows up in the kidney problems or a urinary tract infection. urine, it may be a sign of kidney damage. Albumin in the urine is called albuminuria Types of Urine Glucose Test (proteinuria). 1. Clinitest - Is a method of urine testing for sugar (glucose) using a tablet that is dropped into the urine in a test tube. It uses an alkaline copper sulfate reagent tablet to test for Signs of Albumin in the Urine reducing substance e.g. sugars, in urine. - Early stages of kidney damage will mostly be Gives a quantitative result by color changes asymptomatic. The only way to know from green (0.5% glucose) to orange (2% albumin is present in the urine is to have a glucose). urine test - When kidney damage gets worse and large Clinitest has two methods: amounts of protein escape through the urine, the following symptoms may be a. 5-drop method – most common noticed: b. 2-drop method – to detect more extract - Foamy, frothy or bubbly-looking urine percentages when high levels of glucose are - Swelling in your hands, feet, abdomen or found in the urine face 2. Reagent strip test - The reagent strip test is a method of urine Urinalysis using acetic acid testing for sugar using strips that are dipped into the urine in a test tube - In a community setting, urinalysis using 3. Urinalysis using Benedicts solution acetic acid is a good tool for nurses to have an idea about the albumin in the urine. This  is done for people with history of hypertension - Albumin in the urine results: No turbidity - Fainty turbidity - + 1 Heavy turbidity - + 2 Solid (opaque) + 3