Urinalysis

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By nclexnursing

A urinalysis is a collection of physical, chemical, and microscopic tests performed on urine. Several components in the urine are detected and/or measured by the tests, including byproducts of normal and pathological metabolism, cells, cellular fragments, and microorganisms.

The kidneys, two fist-sized organs at the bottom of the ribcage on either side of the spine, create urine. The kidneys filter wastes from the blood, aid in bodily water regulation, and store proteins, electrolytes, and other chemicals that the body can reuse. Urine travels from the kidneys down the ureters to the bladder, then through the urethra and out of the body to eliminate anything that isn’t needed. Urine is typically yellow and clear, however, due to variable ingredients, the color, quantity, concentration, and content of the urine will vary slightly each time a person urinates.

Many illnesses can be discovered early on by looking for compounds in the urine that aren’t ordinarily present and/or monitoring abnormal levels of particular substances. Glucose, protein, bilirubin, red blood cells, white blood cells, crystals, and germs are among the examples. They could be present because of the following reasons:

The body responds to an elevated amount of the chemical in the blood by attempting to remove the excess in the urine.

There is a problem with the kidneys.

As with bacteria and white blood cells, there is a urinary tract infection present.

Three separate testing steps make up a full urinalysis:

Chemical examination, which assesses chemically for about 9 substances that can provide useful information about health and disease and determines the concentration of the urine microscopic examination, which identifies the types of cells, casts, crystals, and other elements such as bacteria and mucus that can be visible in urines. For further information on each of these tests, check the sections below.

When there is an abnormal finding on the visual or chemical test, or if a healthcare practitioner explicitly demands it, a microscopic investigation is usually done.

If the results of urinalysis are abnormal, it may be necessary to repeat the test to see if the results are still abnormal, and/or further urine and blood tests to help establish a diagnosis.

A clean container is used to collect one to two ounces of pee. For accurate results, a large enough sample is necessary.

Urine can be collected at any moment for a urinalysis. Because it is more concentrated and more likely to reveal abnormalities, a first-morning sample may be required in some circumstances.

Only if a urine sample is taken to a healthcare provider’s office or laboratory for processing within a short period of time will it be useful for a urinalysis. If the interval between collection and transport will be more than an hour, the urine should be refrigerated or a preservative added.

There is no need to prepare for the test ahead of time.

What does the test result mean?

Urinalysis results can be interpreted in a variety of ways. Atypical discoveries are a red flag that something isn’t quite right and should be investigated further. Other focused tests, such as a comprehensive metabolic panel (CMP), complete blood count (CBC), renal panel, liver panel, or urine culture, must be used to link the urinalysis results with a person’s symptoms and clinical findings and to seek for the causes of abnormal findings (for urinary tract infection).

The higher the concentration of the unusual component, such as significantly higher levels of glucose, protein, or red blood cells, the more probable there is an issue that needs to be addressed. The results, on the other hand, do not tell the healthcare provider what caused the finding or whether it is a temporary or persistent illness.

See the sections below for further information on what specific results might signify.

  • Visual examination
  • Chemical examination
  • Microscopic examination

See this sample report for an example of a urinalysis lab report.

Visual Inspection

Color of urine

The urine comes in a variety of colors, the most common of which are yellow tones ranging from extremely light or colorless to very dark or amber. A disease process, many drugs (e.g., multivitamins can tint urine bright yellow), or eating particular foods can all cause unusual or irregular urine colors. Some people, for example, may have crimson urine after eating beets; this is due to the natural pigment in beets and is not a cause for concern. Red-colored urine, on the other hand, can occur when blood is present in the urine and can be a sign of sickness or injury to the urinary system. Another example is pee that is yellow-brown or greenish-brown in color, which could indicate bilirubin in the urine.

Urine clarity

The clarity of urine refers to how clear it is. Laboratorians usually use one of the following adjectives to describe the clarity of the urine: clear, slightly hazy, cloudy, or turbid. Urine can be clear or hazy in “normal” circumstances. Mucus, sperm and prostatic fluid, skin cells, normal urine crystals, and contaminants such as body lotions and powders are examples of substances that induce cloudiness but are not harmful. Other things that can cloud urine, such as red blood cells, white blood cells, or bacteria, signal a medical problem that has to be addressed.

Nursing Quiz

Urethritis is an infection of the urethra, which is the tube that carries urine from the kidney out of the body. Urinary tract infections can be caused by a variety of pathogens. Which of the following organisms is more likely to infect reproductive organs in women than it is to induce urethritis in men?

A. Chlamydia
B. E. coli bacteria
C. Herpes simplex virus
D. Neisseria gonorrhoeae, the bacteria that causes gonorrhea

The correct answer is D. The sexually transmitted bacteria Neisseria gonorrhoeae is a common cause of urethritis in men. This bacterium, on the other hand, is more prone to infect the vaginal canal, cervix, uterus, ovaries, and fallopian tubes in women. Other infective species that can cause urethritis in men and women are choices A, B, and C. Choices A and C are sexually transmissible.

Certain symptoms are particularly prevalent in urethritis, regardless of the reason. The most prevalent symptom in both men and women in which of the following?

A. Clear and thin urethral discharge
B. Itching around the urethral opening
C. Pain during urination
D. Yellowish-green, thick urethral discharge

The correct answer is D. Urination causes pain. The most typical symptoms of urethritis in both men and women are pain during urination and a frequent urge to urinate. Some persons have no signs or symptoms. A B and D are all erroneous.

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