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• Although blood is the specimen of choice for many laboratory tests, various other body substances are also analyzed
• The phlebotomist may be involved in obtaining the specimens, test administration, instruction, processing, or merely labeling or transporting the specimens to the lab
• Nonblood body fluids


  Liquid or semiliquid substances produced by the body and found in the intracellular and interstitial spaces and within various organs and body spaces
• Nonblood body fluids


  • Urine
  • Amniotic fluid
  • Cerebrospinal fluid
  • Gastric fluid / Gastric Analysis
  • Nasopharyngeal Secretions
  • Saliva
  • Semen
  • Serous fluid
  • Sputum
  • Sweat
  • Synovial fluid
• Function of nonblood body fluids


  • To serve as a lubricant so that there could be distance between the tissues and surrounding tissues
  • To lubricate the various organs
• Urine


  • The most frequently analyzed nonblood body fluid
  • The focus specimen for clinical microscopy
  • A non-invasive collection procedure
• Urine has been studied since the very beginning of laboratory medicine
• Urine


  • Readily available, easy to collect, and generally inexpensive to test
  • Its analysis can provide information on many of the body's major metabolic functions
• Normal urine color


  • Yellow
  • Dark yellow if concentrated
• Reasons for urine analysis


  • Monitoring wellness
  • Diagnosis and treatment of urinary tract infections
  • Detection and monitoring of metabolic disease
  • Determining the effectiveness or complications of therapy
• Accurate urine test results depend on


  • Collection method
  • Container used
  • Specimen transportation and handling
  • Timeliness of testing
• If urine is not tested in a timely fashion, this results to erroneous results
• Inpatient urine specimen collection


  Typically handled by nursing personnel
• Outpatient urine specimen collection


  Often handled by phlebotomists
• Phlebotomist's role in urine collection


  Must be able to explain urine collection procedures without embarrassing the patient
• If urine specimens are not tested promptly, urine components can change, leading to erroneous test results
• Preferred urine specimen for many tests


  First urine voided (passed naturally from the bladder or urinated) in the morning, because it is the most concentrated
• Common urine tests


  • Routine Urinalysis (UA)
  • Urine Culture and Sensitivity
  • Urine Cytology Studies
  • Urine Drug Screening
  • Urine Glucose and Ketone Testing
  • Urine Pregnancy Testing
• Routine Urinalysis (UA)


  The most commonly requested urine test because it screens for urinary and systemic disorders
• Components of a routine UA


  • Physical analysis
  • Chemical analysis
  • Microscopic analysis of the urine specimen
• Physical analysis


  Macroscopic observation and notation of color, clarity, and odor, as well as measurements of volume and specific gravity (SG) or osmolality
• Chemical analysis


  Can detect bacteria, bilirubin, blood, glucose, ketones, leukocytes, nitrite, protein, urobilinogen, and measure pH and specific gravity
• Chemical analysis method


  Using a plastic reagent strip (dipstick) with pads impregnated with test reagents
• Microscopic analysis


  Identifies urine components such as cells, crystals, and microorganisms by examining a sample of urine sediment under a microscope
• Ideal urine specimen collection for routine UA


  Midstream collection to avoid contamination
• Routine UA specimen container


  Clear, dry, chemically clean containers with tight-fitting lids
• Urine specimen handling


  • Transported to the lab promptly
  • Can be held at room temperature and protected from light for up to 2 hours
  • Specimens held longer should be refrigerated
• Urine Culture and Sensitivity (C&S)


  • Involves placing a measured portion of urine on a special nutrient medium, incubating it, checking for growth, and identifying any microorganisms that grow
  • If a microorganism is identified, a sensitivity or antibiotic susceptibility test is performed
• Urine C&S specimen


  Must be collected in a sterile container, following midstream clean-catch procedures
• Urine Cytology Studies


  Performed to detect cancer, cytomegalovirus, and other viral and inflammatory diseases of the bladder and other structures of the urinary system
• Urine Cytology specimen


  Fresh clean-catch specimen, examined as soon after collection as possible
• Urine Drug Screening


  Performed to detect illicit use of recreational drugs, use of anabolic steroids, and unwarranted use of prescription drugs
• Urine preferred for drug screening


  Many drugs can be detected in urine but not blood
• Urine Glucose and Ketone Testing


  Used to screen for diabetes and monitor glucose and ketone levels in diabetics
• Urine Pregnancy Testing


  Confirms pregnancy by testing for the presence of human chorionic gonadotropin (HCG)
• Types of urine specimens


  • Random
  • First morning / 8-hour specimen
  • Fasting
• Random urine specimen


  Can be collected at any time, used primarily for routine urinalysis and screening tests
• First morning / 8-hour urine specimen


  Collected immediately upon awakening in the morning after approximately 8 hours of sleep, normally more concentrated
• Fasting specimen


  Typically used for glucose testing
• Types of urine specimens


  • Random
  • First morning / 8-hour
  • Fasting
  • Timed