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Urinalysis

Aim To identify the purpose, method and value of testing urine. Urinalysis. Objectives. To identify the purpose of urinalysis To identify the benefits of urinalysis To identify the importance a clean sample of urine To identify normal and abnormal parameters in urinalysis.

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Urinalysis

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  1. Aim To identify the purpose, method and value of testing urine Urinalysis

  2. Objectives • To identify the purpose of urinalysis • To identify the benefits of urinalysis • To identify the importance a clean sample of urine • To identify normal and abnormal parameters in urinalysis

  3. Urine Testing Urinalysis is the testing of the physical characteristics and composition of a urine. It is used as a baseline test in the assessment of health Urinalysis composition can change due to disease processes The presence of abnormalities in urine can be a warning sign of illness

  4. Clinical Observation • Colour • Clarity • Odour

  5. Reagent strips • Specific gravity • pH • Protein • Blood • Glucose • Ketones • Leucocytes • Nitrites • Bilirubin

  6. Obtaining a good sample! Explanation Infection prevention Obtaining a sample Testing the sample

  7. Findings …….. • Specific gravity measures the concentration of particles in a solution, the amount of dissolved substances in urine. • Normal 1.002 – 1.035 • Abnormal – very weak or concentrated

  8. Possible causes • Concentrated • Insufficient fluid intake • Following exercise/perspiration • Excess secretion of ADH • Alcoholism • Kidney stones • Renal failure

  9. Possible causes • Dilute • Excess fluid intake • Diabetes mellitus • Diabetes insipidus • Renal dysfunction • Diuretics

  10. Findings……. • Ph – this indicates the acidity or alkalinity of urine • Normal is slightly acidic pH 6 (4.6 -8) • Abnormal Acidic Alkaline

  11. Acid Acidic drinks Potassium citrate Kidney stones Renal tubular acidosis Alkaline Hypertension Proteus mirabilis Struvite Possible causes

  12. Findings ……. • Protein Proteinuria is defined as urinary protein excretion of greater than 150 mg per day • Normal identified between 0-8mg/dl • Abnormal finding

  13. Possible causes • Pre-eclampsia • Renal failure – unable to reabsorb protein • Nephrotic syndrome • Hypertension • Dehydration • Renal tumour • Diabetes mellitus • Some medication – ACE inhibitors, opiates, NSAIDs

  14. Findings ….. • Blood - Haematuria Blood in the urine, it may or may not be accompanied by pain, but it is always abnormal and should be further investigated • Normal – no evidence • Abnormal –microscopic or macroscopic

  15. UTI Hypertension Renal disease Tumour in urinary tract Bladder tumour Bladder or kidney stones Prostate cancer Prostatitis March haematuria Possible causes

  16. Findings …….. • Glucose – glycosurea a presence of ‘sugar’ in the urine • Normal – no glucose • Abnormal

  17. Possible causes • Diabetes mellitus • Pancreatitis • Pregnancy • Hyperthyroidism • Renal failure/dysfunction

  18. Findings …… • Ketones – ketonuria produced as a result of fat metabolism, suggesting that fat is being used up as an energy source • Normal result – negative • Abnormal

  19. Possible causes • Dehydration • Crash dieting eg. Atkins • Diabetic ketoacidosis • Insulin overdose • Nausea and vomiting • Starvation • Severe stress • Severe fever due to infection

  20. Findings ……. • Leucocytes – Pyuria an enzyme which is present in most white blood cells, a few found normally in urine • Normal – negative result • Abnormality

  21. Possible causes • UTI • Kidney infection • Cystitis • Urethritis • Pregnancy

  22. Findings ……. • Nitrites salts found in the body which • Normal - negative • Abnormal finding

  23. Possible causes • UTI • Bacterial prostatitis • pyelonephritis

  24. Findings …… • Bilirubin – bilirubinuria a breakdown of haemoglobin not normally present in normal individuals • Normal – negative • Abnormal

  25. Possible causes • Biliary stricture • Bile duct obstruction • Gall stones • cirrhosis • tumours of liver / gall bladder

  26. So testing is important… • What have I learnt? • Questions ?

  27. Thank you!

  28. References • Corbett J V Laboratory tests and diagnostic procedures 5th Ed New Jersey Prentice Hall Inc 2000 • The Royal Marsden Hospital Manual of Clinical Nursing Procedures, 7th edition • NICE Infection control, prevention of healthcare-associated infection in primary and community care June 2003

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