CHARACTERISTICS OF URINE

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Urinalysis

1. Physical characteristics: color, odor, turbidity, volume, & specific gravity

2. Chemical characteristics: pH, glucose, protein, ketones, pus (WBC’s & bacteria), RBC’s, hemoglobin, bile . . .

3. Microscopic exam of urine sediment: crystals, cells, etc.

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

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

List the three main organic solutes of urine

• Urea, creatinine, & uric acid

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List the three main inorganic solutes of urine

• Sodium, potassium, & chloride

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State the average daily urine output

• 1200 - 1500 mL (1.2 - 1.5 L)

State the normal daily range of urine output

• 600 - 2000 mL (0.6 - 2.0 L)

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

• Random

• 1st morning

• Mid-stream clean catch (MSCC)

• Fasting

• 24 hour

List the normal colors of urine• Any shade of yellow due to the pigment

urochrome: light yellow, yellow, dark yellow, amber . . .

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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

• Turbidity - “cloudiness” due to

particulate matter

suspended in urine

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

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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.

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Define specific gravity

• Density of a substance compared to an equal volume of water at a similar temperature

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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

State the normal range of specific gravity for human

urine

• 1.001 - 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

• 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

• Diabetes insipidus (water diabetes)

• Renal (kidney) disease/damage

Chemical Tests for Urine - pHAverage Range: 4.5 - 8.0 Average: 6.0Affected 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 -UTIEither: medications, kidney stones (renal calculi)

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)

• Benign: -cold -strenuous exercise -acute illness (fever) -orthostatic proteinuria • Pathologic: -*kidney damage*

-pre-eclampsia -hypertension -multiple myeloma

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)

• 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)

• Hemoglobin = clear, red appearance

-hemolytic anemia

-transfusion reactions

-severe burns

Chemical Tests for Urine - Bile (bilirubinuria)

-hepatitis/liver disease

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

End.

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