URINE TESTING

URINE TESTING

OBJECTIVES:

1. define the following terms:

a urine
b urine testing
c hematuria
d pyuria
e dysuria
f anuria
g ketone bodies
h uric acid
i gestational diabetes

2. give the importance and purpose of urine testing

3. list the indications and contraindications

4. enumerate factors affecting urination

5. tabulate characteristics of normal and abnormal urine in their corresponding significance

6. state the different methods of urine collection

7. identify guideline principles involved in urine testing

8. explain guidelines in urine testing

9. demonstrate beginning skills in performing urine testing














I. Definition of Terms:

URINE
 waste product excreted by the kidney

URINE TESTING
 used to determine any abnormalities in the urine

HEMATURIA
 discharge of urine containing blood

PYURIA
 abnormal presence of pus in the urine

DYSURIA
 painful or difficulty in voiding

ANURIA
 voiding less than 100ml a day

KETONE BODIES
 are products of fat metabolism and appear in the urine

DIURETICS
 medicine which stimulates flow of urine

URIC ACID
 end product of purine metabolism
 acid in the urine

GESTATIONAL DIABETES
 a disorder characterized by an impaired ability to metabolize carbohydrate usually caused by a deficiency of insulin occurring in pregnancy


IMPORTANCE AND PURPOSE OF URINE TESTING

1. to determine any abnormalities in the urine
2. to monitor proper functioning of liver and kidney
3. to determine the presence
4. helps determine patient’s hydration status
5. to determine disorders of glucose metabolism
6. to determine the acidity and alkalinity if urine



INDICATIONS:
 urine testing is utilized for physical exam
 used for any suspected Urinary Tract Infection
 for pregnancy evaluation; to know whether the female is pregnant or not
 for felt pain during urination


CONTRAINDICATIONS:
 for patient who does not feel the urge to void
 those who has renal failure
 females who has an on-going menstruation
 patients who just had an operation in the genitals
 panuresis/ shy bladder patients-person who finds it difficult or impossible to urinate
when other people are around



FACTORS AFFECTING URINATION

1. Growth & Development
- a child is unable to control micturation, until the age of 18-24 mos.

2. Socio- Cultural
- the habits of micturation are no exception. North Americans expect toilet facilities to be private, where as Europeans accept less private communal facilities, as a way of life

3. Personal Habits
- some people follow complex routines before defecation. Usually fewer rituals precede urination. Privacy is the most essential condition for most people.

4. Muscle Tone
- weakness of abdominal & pelvic floor muscles impair bladder contraction & control of the external sphincter

5. Medication
- various medications influence the volume of urine. Diuretics prevent the reabsorption of water & certain electrolytes in the kidney tubules, resulting in urine.
- Examples:
Levadope & Pyridium- causes urine discoloration
Chlorothiazide & Hydrochlothiazide- causes the kidneys to get rid of unneeded water & salts from the body into the urine
Other diuretics:
furosemide- is a potent diuretic (water pill), in the kidneys, salt (composed
of sodium and chloride), water, and other small molecules
normally are filtered out of the blood and into the tubules of the
kidney. The filtered fluid ultimately becomes urine
triamterene- helps make more urine and to lose the extra water from your
body. This medicine is used to treat high blood pressure and
edema or swelling from excess water.

6. Fluid Intake
- increase in fluid intake, increase urination
- Example
Increased intake of water can be a factor for the frequency of urination


METHODS OF URINE COLLECTION
a. URINALYSIS
- analysis of the urine
- consist of screening for urinary infection, renal disease & diabetes Mellitus
- measures urine color, Ph, & specific gravity
- determines presence of glucose & blood in the urine
- performed by collecting a urine sample from the patient in a specimen cup. Usually only small amounts (10-15 ml's) may be required

b. MIDSTREAN SPECIMEN
- this is ideal for adults, and for children who are continent and can void their bladder on request

c. CLEAN- CATCH SPECIMEN
- this is collected by having the sterile container with lid removed easily available, so that the sample can be easily collected if the person voids

d. SPECIMENS FROM ABSORBENT PADS
- the pads are placed inside a clean nappy(diapers)and then checked every 10 minutes until wet (but not soiled). The urine is then aspirated with a
syringe


GUIDELINES IN URINE TESTING

 Nurse is responsible for instructing client abut urine collection or for obtaining a
sample urine from the client.
 know the voiding status of the patient
 provide fluids to drink 30 minutes before the collection
 Explanation to the short & careful documentation of the type of specimen, collection
site, date & time are the vital nursing interventions.
 the containers used for the urine collection must be clean.




PRINCIPLES INVOLVED IN URINE TESTING

1. ANATOMY
- the urinary is hallow, muscular & distensible organ that sits on the pelvic

2. MICROBIOLOGY
- the nurse must do the special precautions which are neede in the care of the incontinent patients to keep the skin dry & avoid infection

3. CHEMISTRY
- the use of Benedict’s solution to determine the volume of sugar present in the urine Ph of the urine which indicates the acid-based organic waste

4. PHARMACOLOGY
- diuretics are drugs that are used to increase urine output

5. PHYSICS
- specific gravity of urine is the relation it bears to the weight of water

6. PSYCHOLOGY
- frequent urination may be caused by excitement, anxiety or fear. The client must be relaxed