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CHARACTERISTICS OF URINE. Urinalysis. Physical characteristics: color, odor, turbidity, volume, & specific gravity Chemical characteristics: pH, glucose, protein, ketones, pus (WBC’s & bacteria), RBC’s, hemoglobin, bile . . . Microscopic exam of urine sediment: crystals, cells, etc.

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urinalysis
Urinalysis
  • Physical characteristics: color, odor,

turbidity, volume, & specific gravity

  • Chemical characteristics: pH, glucose, protein, ketones, pus (WBC’s & bacteria), RBC’s, hemoglobin, bile . . .
  • Microscopic exam of urine sediment: crystals, cells, etc.
why is urinalysis an important part of routine patient exams
Why is urinalysis an important part of routine patient exams?
  • Urine contains important metabolic information & the presence of abnormal substances is helpful in disease diagnosis
  • Urine is cheap, simple, & readily available
slide4
Odor
  • Fresh urine has a slight characteristic odor but drugs such as nicotine, veggies such as asparagus, & diseases such as PKU or diabetes can alter odor

Standing (“old”) urine takes on an ammonia odor due to bacterial action on urine solutes

state the average daily urine output
State the average daily urine output
  • 1200 - 1500 mL (1.2 - 1.5 L)
define the following terms
Define the following terms:
  • Anuria - complete stoppage of urine
  • Oliguria - reduced amount of urine
  • Polyuria - increased amount of urine
  • Nocturia - increased amount of urine @

night

describe the different types of urine specimens used in a medical lab
Describe the different types of urine specimens used in a medical lab
  • Random
  • 1st morning
  • Mid-stream clean catch (MSCC)
  • Fasting
  • 24 hour
list the normal colors of urine
List the normal colors of urine
  • Any shade of yellow due to the pigment urochrome: light yellow, yellow, dark yellow, amber . . .
list abnormal colors of urine possible causes
List abnormal colors of urine & possible causes
  • Colorless - XS fluid intake; diabetes
  • Orange - bilirubin, XS Vitamin A
  • Green - bile, Pseudomonas bacteria
  • Red/Brown - hemoglobin, beets
  • Black - melanins
  • Any abnormal color can be due to dyes, foods, or medications
state the term used to describe urine appearance
State the term used to describe urine appearance
  • Turbidity - “cloudiness” due to

particulate matter

suspended in urine

Clear, transparent, hazy, cloudy, turbid, milky, or 0 - 4+ system

identify several factors that may affect urine appearance
Identify several factors that may affect urine appearance
  • Crystals, WBC’s, RBC’s, bacteria, epithelial cells, lipids, mucus, fecal material, semen, lymph fluid, yeast, powders, creams, cotton fibers, etc.
define specific gravity
Define specific gravity
  • Density of a substance compared to an equal volume of water at a similar temperature
describe a urinometer the procedure for using it to determine s g of urine
Describe a urinometer & the procedure for using it to determine s.g. of urine
  • A device that displaces water and sinks to a level indicative of the specific gravity
  • Pour urine in jar, place urinometer in fluid, spin & when it settles, read the results
explain the significance of a specific gravity of 1 023 1 035
Explain the significance of a specific gravity of 1.023 - 1.035
  • Normal; 1.023 or above indicates good kidney function
list 4 common reasons for abnormally high specific gravity results
List 4 common reasons for abnormally high specific gravity results
  • Presence of glucose
  • Presence of protein
  • Recent X-ray exposure
  • Use of IV’s
  • Dehydrating illnesses - fever, sweat, vomit, diarrhea
list possible reasons for abnormally low specific gravity results
List possible reasons for abnormally low specific gravity results
  • Diabetes insipidus (water diabetes)
  • Renal (kidney) disease/damage
chemical tests for urine ph
Chemical Tests for Urine - pH

Average Range: 4.5 - 8.0 Average: 6.0

Affected by diet & changes in body metabolism

Acidic urine: -high protein diet or lots of

whole wheat = acid forming

foods

-diabetes

Alkaline urine: -high veggie or dairy diet = base

forming foods

-UTI

Either: medications, kidney stones (renal calculi)

chemical tests for urine glucose glycosuria
Chemical Tests for Urine - Glucose (glycosuria)
  • Benign: -heavy meal

-emotional stress

  • Pathologic: -diabetes mellitus

-kidney tubule defects

-CNS damage

-thyroid disorders

chemical tests for urine protein proteinuria
Chemical Tests for Urine - Protein (proteinuria)
  • Benign: -cold

-strenuous exercise

-acute illness (fever)

-orthostatic proteinuria

  • Pathologic: -*kidney damage*

-pre-eclampsia

-hypertension

-multiple myeloma

chemical tests for urine pus pyuria
Chemical Tests for Urine - Pus (Pyuria)
  • UTI (Urinary Tract Infection) or

contaminated specimen

  • High Risk for UTI:

-School age children esp. girls

-pregnant women

-diabetic people

-previous history of UTI’s

-patients with catheters

-elderly people

chemical tests for urine rbc s hematuria
Chemical Tests for Urine - RBC’s (Hematuria)
  • Whole blood = cloudy red
  • Bleeding in the urinary tract

-trauma (ex: auto accident, kick)

-kidney stones (renal calculi)

-kidney infection (pyelonephritis)

-tumors

-toxic chemicals/drugs

chemical tests for urine hemoglobin hemoglobinuria
Chemical Tests for Urine - Hemoglobin (hemoglobinuria)
  • Hemoglobin = clear, red appearance

-hemolytic anemia

-transfusion reactions

-severe burns

chemical tests for urine ketones ketonuria
Chemical Tests for Urine - Ketones (ketonuria)
  • Source: breakdown of fats instead of

carbohydrates for energy

-diabetes

-starvation (decreased carbohydrate

intake or increase carbohydrate loss -

vomiting)

-wrong dose of insulin