URINALYSIS This is part of routine diagnostic and screening evaluations.

It can reveal a significant amount of preliminary information about the kidneys and other metabolic processes. It is done diagnostically in patients with abdominal or back pain, dysuria, hematuria and urinary frequency. It is part of routine monitoring in patients with chronic renal disease and some metabolic disease. Date N O V E M B E R 1 6 , 2 0 1 0 Diagnostic Exam Clinical microscopy: Urine Specimen (Urinalysis) Purpose Normal Results Result Clinical Significance Nursing Interventions Instruct patient to wash and dry genitalia with soap and

To screen for urinary tract disorders, kidney disorders, urinary neoplasm and other medical conditions that produce changes in the urine. This test also is used to monitor the effects of treatment of known renal or urinary condition.

water prior to urine collection. Give clean specimen Fbottle to the patient and instruct him/her to void directly into the 55

Women should not collect urine during menstruation. feces or secretions. must not be contaminated by toilet Physical Examination: Color Pale to yellow Yellow (normal) Amber Colorless: overhydration. paper. preferably on arising in the morning.specimen bottle Instruct the patient to collect a sample of urine. diabetes insipidus and mellitus Dark red or pink: porphyria. Instruct patient to collect a 56 . diuretic therapy. hematuria. toilet water.

Specimen Appearance Clear Cloudy Cloudy.ingestion of red food coloring. beets. bacteria and phosphates in urine must be delivered to the laboratory immediately. berries. smoky or hazy: pyuria. bacteriuria. The lid must be sealed completely and the container must be labeled properly. rhubarb Dark yellow: bile Green: pseudomonas bacteriuria. 57 . urinary bile Pigments midstream voided specimen.pus. fava beans.

pyelonephritis. SIADH Decreased in: overhydration. CHF. fever. vomiting.025 (normal) The urine specific gravity test reveals how concentrated or dilute the urine is Increased in: dehydration. hypotension. diarrhea. renal tubular 58 .Specific gravity 1.1.010.030 1. profuse sweating. adrenal insufficiency. glycosuria. glomerulonephritis. dieresis. proteinuria.

dysfunction. Negative Positive Positive in: a sign of positive pregnancy and is also indicative of other renal disorders Sugar - Used to monitor persons with diabetes Negative Negative Positive in: hyperglycemia. diabetes mellitus 59 . severe renal damage. diabetes insipidus Chemical Examination: Albumin - Albumin is important in determining the presence of glomerular damage.

Pus cells ” 4 cells/hpf 3 -5 /hpf Positive in: urinary tract infection (UTI) Red blood cells >2 hpf 6 -10/hpf Greater than normal numbers of red blood cells in 60 .Microscopic examination: Epithelial cells ” 4 cells/hpf + Their significance is that they represent possible contamination of the specimen with skin flora.

Pyelonephritis (kidney infection). Prostatitis + Mucus is a frequent finding of the urinary sediment.the urine may indicate: Acute tubular necrosis. The exact function of mucus is unknown. Kidney trauma. Kidney tumor. Glomerulonephritis. Cystitis (bladder infection). Interstitial nephritis. Kidney stones. Menstrual bleeding. This action is done 61 Mucous Threads . Some think that this substance is a protection against bacterial infection.

The mucus coated bacteria are eliminated through micturition (urinating). Mucus can also protect the lower urinary tract against irritating chemical agents.by coating the bacterial pili (hair like things covering some bacteria which make them sticky). Bacteria + Bacteria are common in urine specimens because of the abundant normal microbial flora of the vagina or external urethral meatus and because of their ability to rapidly multiply in urine standing at room 62 . essential to colonization of the lower urinary tract wall.

Therefore. 63 .temperature. Diagnosis of bacteriuria in a case of suspected urinary tract infection requires culture. microbial organisms found in all but the most scrupulously collected urines should be interpreted in view of clinical symptoms.

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