Urinalysis Testing urine is known as urinalysis. It is performed when; A patient is admitted to hospital. May be repeated whilst the patient is in hospital again. And any time it is prescribed. 1

Mid stream urine test The sample should be taken without contamination from the external genitals, and the mid stream urine means that only the middle part of the urine stream is collected. Therefore it is important to clean the external genitalia in both males and females before urinating to prevent contamination. This process is difficult to obtain at times and therefore a clean catch urine may be preferred. ( ) 2

process Obtain urine free from contamination. A clean dry container should be used to hold the urine. Follow manufactures instructions. Check the expiry date. Avoid unnecessary exposure to air, light and moisture. Do not transfer agent from their original bottles into others Time test accurately If abnormalities are detected do not discard specimen. Report and document the results immediately. Dispose of all material strips, etc appropriately. Wear goggles throughout the procedure. 3

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Urinalysis cont… Urine being tested should be fresh - why do you think this is important? 5

Chemical reagent strips Are used to test urine, and urinalyis provides information about; The condition and function of the urinary system. The presence of pathogenic micro organisms in the urinary tract or urine. The presence of unrelated disorders of the urinary system. The acid base balance of the body. The presence of nutrient materials that are normally transported to the body cells, but which may have been excreted in the urine, eg glucose. 6

Chemical reagent strips cont…. The presence of systemic disease which in unrelated to disorders of the urinary system The acid base balance of the body (chandler 1995,p 258) 7

CharacteristicnormalabnormalPossible cause Amount in 24 hours (Adult) Under 1200mls Decreased fluid intake kidney failure colourStraw - amber Dark amberInsufficient fluid intake resulting in concentrated urine transparent Cloudy dark orange Infectious process drugs Red or dark brown Disease causing blood in urine 8

characteristic s normalAbnormalPossible cause odourFaint aromaticOffensive foul smelling Infection Presence of glucose Diabetes mellitus Foreign substances nilPus Stones or gravel UTI Urinary calculi sterilityNo micro organisms Micro organisims present Infection of urinary tract 9

characteristicnormalabnormalPossible cause ph4.5 to 8Under 4.5 over 8 Uncontrolled diabetes, starvation, dehydration Specific gravity 1010 to 1025 Under 1010 Diabetes insipidus. Kidney disease, over hydration glucoseNot present present Diabetes mellitus Ketone bodiesNot present present Diabetic coma Starvation Prolonged vomiting 10

Assessement of urine Involves measuring the volume. Comparing output to input. Inspecting colour, clarity, odour. Testing the urine for specific gravity, glucose, ketone bodies, blood, and pH. 11

Specific gravity Is the weight or degree of concentration of a substance compared with that of an equal volume of another, such as pure distilled water taken as a standard. 12

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Limitations of urinalysis Many of the dipstick results aren't completely accurate, and sometimes gives you positive results that aren't true. The test relies on correct collection of sample by the patient, and if this is not done properly the results may be inaccurate Many of the abnormalities seen with urinalysis can be found in normal people 14