14.2 Urinary System

Ch 14 Urinary System

• ​14.1 Anatomy of the Urinary System

• 14.2 Urinalysis test

• 14.3 Kidney Function and Physiology

14.2 Urinary System

• ​Color

  • urochrome (breakdown of hemoglobin)

    • hydration state

• Odor

  • Time + bacteria= ammonia ​

• Specific Gravity

  • density ratio to distilled water

• pH

  • 6.0 metabolic acidic waste

• Chemical composition

  • urea (most abundant)​

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Urine Compisition

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Urine Collection

• Voided sample: collected as the person is urinating. It should be collected midstream, and the container must be sterile.

• Bladder expression - The bladder is palpated, and urine is manually expressed with pressure.

• Catheterization is when the nurse places a plastic tube, known as a catheter, into the urethra.

• Cystocentesis - A sterile needle is passed through the abdominal wall into a full bladder, and urine is withdrawn directly into the sterile syringe. 

Gross Examination

• Color - Normal is shades of yellow

• Clarity and consistency - Clear, cloudy, turbid (containing particles)

• Odor - Ammonia, Sweet, fruity

• Presence of foam - When shaken, it produces a small amount of white foam.

Multiple Choice

A urine sample that is turbid is said to be

• Cloudy
• Clear
• Odorous
• Dark
• Dilute

Specific Gravity Test

measures urine solute concentrations

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Specific gravity is measured in comparison to the SG of distilled water 1.00

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​Normal 1.005 -1.030

Though can vary

Usually, it is just a marker test to ​collaborate results from other tests

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​High- dehydration, proteins, glucose...

Low- ​Electrolyte or hormone imbalances

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pH Test

​metabolic or respiratory Acid-Base homeostasis or renal tubular disorders (no set norm value)

common causes: ​

Low pH

• protein diets

• cranberry juice

​High pH

• vegetarian diets​

Multiple Choice

normal urine pH is

• neutral

• acidic

• basic

• limitless

Protein Test

​A protein test is an indication of renal dysfunction​

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Proteinuria - Albumin (liver protein) and uromodulin are found in urine.

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Increased glomerular pressure or damage can lead to proteinuria

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Urine has a foamy appearance

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proteinuria

​Albumin Creatine Ratio Test

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Creatine is an amino acid produced by normal muscle metabolism.

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The UACR and GFR (glomerular filtration rate) help to identify

• kidney dysfunction.

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Multiple Choice

a patient's urine sample and their chart indicates they have edema in their feet, which urinalysis test would most commonly be positive?

• nitrite

• hematuria

• proteinuria

• pH

Glucose Test

 glucose is abnormally eliminated in the urine due to improper functioning of the renal tubules

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Glycosuria- high glucose concentration in the urine​

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Indication of​:

• ​elevated plasma glucose

• renal absorption ​impairment

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ketone Test

Ketone bodies are a byproduct of glycogen breakdown, muscle, and fat being utilized for metabolic energy

Used to monitor type 1 diabetes ​

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Ketonuria - ​increased glycogen breakdown as a result of insulin deficiency

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Indication of:

• electrolyte imbalance

• ketoacidosis

• ​dehydration

• diabetic coma​

Blood Test

​Test for the presence of blood or blood cell fragments in the urine

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Hematuria- the presence of ​intact or fragments of RBCs in the urine

• Microscopic

• Macroscopic​

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Indication of:

• ​Kidney infection

• Kid​ney stones

• Urinary System ​Cancers

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Urobilinogen and Bilirubin Test

​Urobilinogen is formed from the natural breakdown of Bilirubin

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Bilirubin is formed from the natural breakdown of hemoglobin

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Urine should not contain Bilirubin and only trace amounts of Urobilinogen

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​Indication of:

• Bile duct obstruction

• Liver damage​

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​0.1 - 1 normal range

Multiple Select

check all that apply, urinalysis test that can detect liver dysfunction

• urobilinogen

• bilirubin

• nitrite

• blood

• pH

Nitrite and Leukocyte Test

Leukocyte test identifies if the body's immune response ​is activated due to infection or inflammation

Leukocyturia- WBCs in urine​

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Nitrite test identifies the presence of nitrate reductase produced by certain bacteria

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Indication of:

• Infections

• Inflammation