Term
| Who were the first to examine urine? What properties did they look at? (5) |
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Definition
cavemen & Egyptians
color, clarity, odor, viscosity, sweetness |
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Term
| Who wrote a uroscopy book in 5th century B.C.? |
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Definition
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Term
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Definition
"pisse prophets"
1st medical licensure laws |
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Term
| When did UA become part of a routine physical? |
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Definition
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Term
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Definition
| easily obtained specimen to assess many metabolic functions w/inexpensive tests |
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Term
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Definition
| "the testing or urine with procedures commonly performed in an expeditious, reliable, safe, and cost-effective manner" |
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Term
| 3 reasons to perform UA tests |
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Definition
aid disease diagnosis
screen for asymptomatic diseases
monitor disease progress & therapy effectiveness |
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Term
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Definition
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Term
| solute variations in urine (6) |
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Definition
diet
activity
metabolism
endocrine
body position
hormone balance |
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Term
| What is the major organic solute? and 2 others |
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Definition
urea (protein, amino acid breakdown)
creatinine
uric acid |
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Term
| Where can urea, creatinine, and uric acid be measured? |
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Definition
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Term
| What (2) identify fluid as urine? |
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Definition
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Term
| inorganic stuff in urine (3) |
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Definition
K, Na, Cl
potassium, sodium, chloride |
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Term
| what makes establishing normal values difficult? |
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Definition
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Term
| What may indicate disease? |
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Definition
| formed elements not part of ultrafiltrate |
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Term
| What is urine volume determined by? |
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Definition
| body's state of hydration |
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Term
| What influences urine volume? (4) |
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Definition
fluid intake
nonrenal fluid loss
antidiuretic hormone (ADH) variations
excretion of large amounts of dissolved solids |
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Term
| What are examples of nonrenal fluid loss? |
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Definition
| vomiting, diarrhea, starving |
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Term
| Who would excrete large amounts of dissolved solids? |
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Definition
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Term
| What is the usual daily urine volume? |
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Definition
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Term
| What is the normal range of urine volume? |
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Definition
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Term
| definition of oliguria & causes (4) |
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Definition
adults: < 400 mL/day
vomiting, diarrhea, perspiration, severe burns |
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Term
| definition of anuria & consequences |
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Definition
cessation of urine flow
severe kidney damage, decreased renal blood flow (from shock, decrease in pressure throughout body) |
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Term
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Definition
| increased urine excretion at night |
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Term
| normally, day excretion is _ times more than night. |
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Definition
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Term
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Definition
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Term
| What is a result of diabetes mellitus and insipidus? |
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Definition
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Term
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Definition
increased vol b/c need to excrete excess glucose not reabsorbed from ultrafiltrate
(decreased/function of insulin)
polydypsia
dilute urine w/high specific gravity |
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Term
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Definition
decreased production/function of ADH causing decreased reabsorption of water from ultrafiltrate
dilute urine w/low specific gravity (pale, light color)
polydypsia |
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Term
| What is recommended for specimen collection? |
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Definition
disposable, wide-mouthed, flat-bottom containers with screw caps
clear container w/at least 50 mL capacity
adhesive bags for pediatrics & large plastic containers for 24-hours specimens
(wear gloves!) |
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Term
| info on specimen label (4) |
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Definition
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Term
| additional info on specimen label (3) |
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Definition
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Term
| Where should the label be placed? |
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Definition
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Term
| Where should the label not be placed? |
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Definition
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Term
| What must accompany the specimen? |
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Definition
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Term
| Information on requisition form must match _. |
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Definition
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Term
| What is stamped on requisition? (1) |
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Definition
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Term
| Other info on requisition? (2) |
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Definition
type of specimen
interfering meds |
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Term
| Why would a specimen be rejected? (6) |
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Definition
unlabeled containers
non-matching labels + requisitions
contaminated specimens - feces, paper
contaminated containers
insufficient quantity
delayed/improper transport (no ice, refrigeration)
according to labs' written policies for rejection |
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Term
| To maintain specimen integrity, (2) |
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Definition
test within 2 hours of collection
refrigerate if delayed testing |
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Term
| Most problems with bad specimen integrity are b/c of _. |
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Definition
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Term
| bad/unpreserved specimen has increased (6) |
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Definition
color
turbidity
pH
nitrite
bacteria
odor |
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Term
| bad/unpreserved specimen has decreased (7) |
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Definition
glucose
ketones
bilirubin
urobilinogen
RBCs
WBCs
casts |
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Term
| What causes modified/darkened color in unpreserved urine? |
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Definition
| oxidation/reduction of metabolites |
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Term
| What causes decreased clarity in unpreserved urine? |
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Definition
| bacterial growth & precipitation of amorphous material |
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Term
| What causes increased odor in unpreserved urine? |
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Definition
| multiplication of bacteria or bacterial breakdown of urea to ammonia |
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Term
| What causes pH to increase in unpreserved urine? |
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Definition
| breakdown of urea to ammonia by urease-producing bacteria/loss of CO2 |
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Term
| What causes decreased glucose in unpreserved urine? |
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Definition
| glycolysis & bacterial utilization |
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Term
| What causes decreased ketones in unpreserved urine? |
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Definition
| volatilization & bacterial metabolism |
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Term
| What causes decreased bilirubin in unpreserved urine? |
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Definition
| exposure to light/photo oxidation to biliverdin |
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Term
| What causes decreased urobilinogen in unpreserved urine? (1) |
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Definition
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Term
| What causes increased nitrite in unpreserved urine? (1) |
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Definition
| multiplication of nitrate-reducing bacteria |
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Term
| What causes decreased blood cells & casts in unpreserved urine? (1) |
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Definition
| disintegration in dilute alkaline urine |
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Term
| What causes increased bacteria in unpreserved urine? (1) |
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Definition
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Term
| What is ideal specimen preservation? (1) Why? (2) |
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Definition
| bactericidal - inhibits urease & preserves formed elements |
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Term
| What is routine in specimen preservation? (1) |
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Definition
| refrigeration - must for culture specimens |
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Term
| What happens when you refrigerate a specimen? |
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Definition
precipitation of amorphous crystals
must return to room temp for chemical testing |
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Term
| Commercial transport tubes are available but must be _ with tests. |
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Definition
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Term
| What does the composition of urine depend on? (3) |
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Definition
pt's metabolic state
timing & procedure used for collection |
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Term
| Patients must be _ when special collection techniques are required. |
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Definition
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Term
| What is the most common type of specimen received? |
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Definition
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Term
| What are random specimens screened for? |
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Definition
| routine screening for obvious abnormalities |
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Term
| When can a random specimen be collected? |
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Definition
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Term
| What may alter results of random specimen? |
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Definition
| dietary intake & activity |
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Term
| After a random specimen, patients may have to do what? |
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Definition
| collect a follow-up specimen |
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Term
| What is the ideal screening specimen? |
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Definition
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Term
| What is more concentrated than random specimen? |
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Definition
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Term
| Patient is in a _ state when first morning specimen is collected. |
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Definition
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Term
| What is used for orthostatic protein confirmation and urine pregnancy tests? |
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Definition
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Term
| When is first morning specimen collected and delivered? |
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Definition
| immediately on arising; within 2 hours |
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Term
| What is specific gravity of first morning specimen? |
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Definition
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Term
| What is the 2nd specimen voided (collected after 1st morning specimen)? |
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Definition
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Term
| What does the fasting specimen not contain? |
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Definition
| metabolites from evening meal |
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Term
| What is fasting specimen recommended for? |
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Definition
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Term
| What does 2-hours postprandial specimen consist of? |
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Definition
pt voids before eating routine meal
eats meal
collects next specimen 2 hours after finishing meal |
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Term
| What does 2-hour postprandial specimen monitor? |
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Definition
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Term
| What can 2-hours postprandial specimen be compared with? (2) |
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Definition
| fasting urine specimen and blood test results |
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Term
| What is an institutional option for collection with blood glucose tolerance test but not frequently done? |
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Definition
| glucose tolerance specimen |
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Term
| When are glucose tolerance specimens collected? |
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Definition
| same intervals as blood samples |
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Term
| What are glucose tolerance specimens used to correlate? |
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Definition
| renal threshold & pt's ability to metabolize glucose |
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Term
| What kind of specimen is required for quantitative results? |
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Definition
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Term
| What are 24-hour specimens used to measure? |
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Definition
substances* with diurnal variation (differ a.m. vs. p.m.)
*substances vary w/meals, activity, body metabolism |
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Term
| _ _ specimens can be used for substances with consistent levels. |
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Definition
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Term
| _ _ is critical for accurate results. |
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Definition
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Term
| timing schedule example for 24-hr timed specimen |
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Definition
Day 1, 7 AM: pt voids & discards urine
begins collecting urine
Day 2, 7 AM: voids & adds urine to specimen container |
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Term
| principle of 24-h timed specimen schedule |
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Definition
| must begin and end with empty bladder |
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Term
| urine collected in 24 hours - units? |
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Definition
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Term
| How do you handle timed specimens? (5) |
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Definition
thoroughly mix specimen & measure
save large enough aliquot to test & repeat if necessary
keep specimen on ice/refrigerated during collection
use appropriate & nontoxic preservatives
review instructions w/pt |
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Term
| What is a catheterized specimen? |
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Definition
| sterile specimen collected from bladder w/catheter |
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Term
| Most common test for culture & sensitivity? |
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Definition
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Term
| What is done 1st to catheterized specimen before performing UA? |
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Definition
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Term
| What is an alternative to catheterized specimen? |
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Definition
| midstream clean-catch specimen (less contaminated than routine collection) |
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Term
| For midstream clean-catch specimen, what do you give the pt (2) and instruct them to do? (5) |
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Definition
mild cleansing material + container
wash hands, clean genitalia w/cleanser, void into toilet, then container, and finish in toilet |
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Term
| What is completely free of contamination for culture and cytology? |
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Definition
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Term
| What is used for suprapubic aspiration? Who would it be done on? |
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Definition
| external needle aspiration from bladder; small bladder/someone w/chlamydia for sterile specimen |
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Term
| How is a pediatric specimen collected? |
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Definition
soft, clear plastic bags with hypoallergenic tape applied to genital area
monitor bag frequently
may use clean-catch method
for timed specimen, bags w/tubes to larger container |
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Term
| For drug specimen collection, what must be documented? (3) |
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Definition
proper collection
labeling
handling |
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Term
| What is included in chain of custody? |
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Definition
documentation from time of specimen collection till time of receipt of lab results
standardized form always accompanies specimen |
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Term
| Drug specimen must withstand _ _. |
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Definition
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Term
| What are points to consider about drug specimen collection? (3ish) |
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Definition
photo ID of urine donor/ID by employer
no unauthorized access to specimen
no adulteration/substitution/dilution of specimen |
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Term
| Test orderer determines what? |
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Definition
| witnessed vs. unwitnessed collection (both handed immediately to collector) |
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Term
| drug specimen collection - adulteration tests? (2) |
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Definition
| temperature & color (unusual) |
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Term
| drug specimen collection - what is normal temp range? |
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Definition
| within 4 min, 32.5-37.7 C |
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Term
| if temp of drug specimen is outside range, what should you do? |
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Definition
| report temps, and collect another asap |
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Term
| What should you follow for labeling, packaging, and transporting drug specimen? |
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Definition
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