mlsp121

• Urine color


  Normal color pale yellow, yellow, dark yellow and amber
• Normal urine volume is 2000ml
• SIMLE


  5/24
• Yellow color urine is caused by the presence of a pigment called urochrome
• Care should be taken to examine the specimens under a good light source, looking down through the container against a white background
• Abnormal urine color


  • Dark Yellow or Amber-presence of the abnormal pigment bilirubin
  • Yellow-organge-administration of phenazopyridine (Pyridium) or an-gantrisin compounds to persons with urinary tract infections
  • Red-Presence of Blood
  • Brown urine containing blood-glomeralar blooding
  • Brown or black-melanin or homogentisic acid levodopa, methydopa, phenol derivatives and metronidazole (Flagy)
  • Blue/green-bacterial infection, including urinary tract infection by Pseudomonas species and intestinal tract infections resulting in increased urinary indican
• Clarity


  Refers to the transparency or turbidity of a urine specimen
• Common terminology used to report clarity

  • clear
  • hary
  • cloudy
  • turbid
  • milky
• Cloudy urine is abnormal
• Urinalysis


  Testing of urine with procedures commonly performed in an expeditious, reliable, safe and cost-effective manner

  
• Reasons for Urinalysis


  • Diagnosis of Disease
  • Screening asymptomatic populations for undetected disorders
  • Monitoring progress of disease and effectiveness of therapy
• Urine Formation


  • Ultrafiltrate of Plasma
  • Formed at Kidneys
  • Average Daily output is 1200mL – 1500mL
• Terminologies Related to Urine Output

  • Normal Daily Output – 1200-1500mL (600-2000mL also considered normal)
  • Oliguria - Decreased Urine Output: 400mL/day (Adults)
  • Anuria – cessation of urine flow; suggests severe kidney damage
  • Nocturia – increased excretion of urine during the night
  • Polyuria – increased Urine Output : >2.5L / day (Adults)
• Urine Composition


  Urine is normally 95% water and 5% Solutes (Organic and Inorganic)
• Organic Solutes in Urine (24-hour Specimen)


  • Urea - 25.0-35.0g (60-90% Nitrogenous material (protein metabolism))
  • Creatinine - 1.5g (Derived from creatine (muscle metabolism))
  • Uric acid - 0.4-1.0g (Common component of Kidney Stones)
  • Hippuric acid - 0.7g (Derived from Benzoic Acid)
  • OTHERS - 2.9g
• Inorganic Solutes in Urine (24-hour Specimen)


  • NaCl - 15.0g (Principal salt)
  • Potassium - 3.3g (Occurs as chloride, sulfate, phosphate salts)
  • Sulfate - 2.5g (Derived from amino acids)
  • Phosphate - 2.5g (Serves as buffers in blood)
  • Ammonium - 0.7g (Derived from protein and glutamine metabolism)
  • Magnesium - 0.1g (Occurs as chloride, sulfate, phosphate salts)
  • Calcium - 0.3g (Occurs as chloride, sulfate, phosphate salts)
• Urine Collection


  • Urine is classified as a BIOHAZARD
  • Observe Standard Precautions
  • Requisition Forms are required

  
• Containers for routine urinalysis

  • Clean and Dry (Sterile)
  • Leak Proof
  • Screw top lids
  • Should have a wide mouth
  • Made of clear material
  • Recommended capacity: 50mL
  • Labelled. (Attached to CONTAINER, not the lid)
• Types of Urine Specimens


  • Most Common – Random Urine
  • Most Preferred – First Morning (Because it is more concentrated)
  • 24 Hour Specimen (For Quantitative Measurements)
  • Suprapubic Aspiration (Commonly done on pediatrics)
  • Catheterized (Collected under sterile conditions by passing a sterile hollow tube through the urethra into the bladder)
  • Midstream Clean-Catch (Alternative to catheterized specimens, Less traumatic, Less contaminated by Epithelial Cells and Bacteria)

  
• Urine Drug Sample Collection

  • Sample collection is the most vulnerable part of Drug Testing
  • Phlebotomist must ensure that no tampering of the specimen was done by the patient
  • Types of tampering: Adulteration, Substitution, Dilution
  • Chain of Custody – Documentation of Sample Handling

  
• Urine Drug Sample Collection

  • May be "Witnessed" or "Unwitnessed'
  • If Witnessed, a same-gender collector will observe the collection
  • 30-45mL of Urine is collected
  • Temperature, pH, Color and Specific Gravity of Urine will be tested immediately

  
• Ideal Urine Temp


  32.5-37.7 C
• Urine pH


  Greater than 9 suggests adulteration
• Specific Gravity


  Less than 1.005 suggests dilution
• Bluing dye is placed on toilets to prevent patients to use toilet water to dilute specimen
• Urine Preservatives


  • Refrigeration (2-8 C) (Doesn't interfere with chemical tests, Raises Specific Gravity, Precipitates Urates and Phosphates)
  • Tolouine (Doesn't interfere with routine test, Floats on surface of specimens and clings to pipettes and testing materials)
  • Sodium fluoride (Ideal for Drug Testing, Inhibits Reagent Strip Tests)
  • Formalin (Preserves Sediments, Interferes with Chemical Tests)
  • Phenol (Doesn't interfere with routine test, Causes Odor Change)
• Urine Specimen should be delivered and tested within 2 hours