Urine Analysis

What are the 3 component of Urinalysis

Physical examination, Chemical examination, Microscopic examination

Physical examination

How the urine looks to the naked eye

• color

• Clarity

• Odors

Chemical examination

A special strip (dipstick) is used to test for substances int he urine sample

• Blood

• Bilirubin

• Glucose

• Proteins

• PH level

• Urobilinogen

Microscopic examination

The urine sample id examined under a microscope to:

• check if there are cells, crystals, urinary casts, mucus or other substances

• Identify any bacteria or other germs

Urinalysis

Is a test of the urine. Often down to check for UTI (urinary tract infection), kidney diseases or diabetes mellitus.

Urinalysis involves checking urine for the following

• Color

• Appearance (whether its cloudy or clear)

• Any odor

• pH level

• Blood, protein, glucose, ketones ad bilirubin

• Cell, crystals, and casts

• Bacteria or any other pathogens

Urine is used for

• Diagnostic testing

• Monitoring of disease status

• Detection of drugs

• All clinical laboratory specimens

Urine collection devices

Urine Collection Containers (cups for collection and transport)

Urine Collection Containers (for 24- hour collection)

Urine Specimen Tubes

Regular Voided Specimen

This collection requires no special patient preparation and is collected by having the patient void urine into a clean urine container

Double-Voided Specimen

This collection requires first emptying the bladder and then waiting a specified amount of time (typically 30 min) before collecting the specimen.

This test is more commonly used to test urine for glucose and ketones.

Midstream Specimen

This collection is preformed to obtain a specimen that is free of genital secretions, pubic hair, and bacteria surrounding the urinary opening.

To collect a midstream specimen, the patient voids the initial urine in the toilet. Collect the middle of the urine and void the last of the urine flow into the toilet.

Midstream Clean-Catch Specimen

This collection it’s collected in a sterile container and yields specimen that is suitable for microbial analysis or culture and sensitivity testing.

This procedure is necessary to ensure that the specimen is free of contaminating matter from the external genital areas.

Special cleaning of this genital area is required before specimen collection

Catheterized Specimen

This Collection is collected from a sterile catheter inserted through urethra into the bladder. This method is used when patient is having trouble voiding or is already catheterized.

Catheterized specimen are sometimes collected on babies to obtain a specimen for Culture & Sensitivity , or bedridden patients

Suprapubic Specimen

This collection is collected by inserting a needle directly into the urinary bladder and aspiring (withdrawing by suction) the urine directly from the bladder into a sterile syringe.

This specimen is then transferred into a sterile urine container or tube.This procedure requires local anesthetic.

This procedure is used for samples for microbial analysis or cytology studies. It is sometimes used to obtain uncontaminated samples from infants and young children.

Timed Collection (24 hours collection)

This collection takes 24 hours of urine specimen. Patients collects their own urine.

Is they start in the morning by discarding the first urine then starting the 24 hours with the date and time. The sample needs to be kept cool until returened back to the lab

Blood Cultures

This is usually collected from patients who have a fever of unknown origin (FUO), Bacteremia (presence of bacteria in the blood) or Septicemia ( presence of pathogens in the bloodstream)

Aerobic bottle first then Anaerobic bottle

Cleanse area twice once with alcohol then povidone iodine.

Throat Swab

Is a culture specimen usually obtained to test for strep throat. Wipe nurse tonsils, the throat and all areas that look inflamed or infected.

Buccal Swab

it’s collected from the inside of the cheek in the mouth to collect a patient’s DNA. Most commonly the collection is performed by gently rubbing sterile swab against the inside of the patients’s cheek.

Semen

Are used to perform sperm counts to help assess fertility. They can also be used to help prove identify in rape cases. Keep specimen warm and protected from the light.

Glucose Tests

-Glucose Tolerance Tests

-Postprandial Glucose Test

-Glucose Monitoring

Glucose Tolerance Test (GTT)

Is the most common timed specimen

For patients who suffer pre-diabetic symptoms

Performed in basal state , not caffeine, smoking then wait for an hour to receive last blood and urine sample. See the curve pre and during and after

Postprandial Glucose Test

2 hour Postprandial (after meal) glucose test

Glucose Monitoring

Point of care testing used to rapidly test glucose levels

Cannulas

Is a tubular instrument that is used in patients with kidney disease to gain access to venous blood for dialysis or blood collection. This blood will be obtained through specially trained personnel

Fistula

Is an artificial shunt in which the vein and artery have been fused through surgery. It is a permanent connection tube located in the arm of the patients undergoing kidney dialysis. Only specialized personnel can collect blood from a fistula

Autologus Blood Donation

If a patient is having surgery with a high risk of bleeding , he/ she can donate to themselves. This reduces the risk of acquiring any blood borne pathogens during transfusion from a donor

Arterial Blood Gases (ABG)

this provides information about the respiratory status and acid base balance of patients with pulmonary disease or disorders. NOT DONE BY PHLEBOTOMISTS

Neonatal Drug Testing

• Detects use of cocaine,opiates, meth which can cause prenatal drug exposure

• 24 hours after childbirth to detect recent drug use

Forensic Specimens

vaginal swabs after rape

Blood and body fluids from crime scenes

Postmortem specimens from autopsies

Blood Alcohol Collection

Driving under the influence (DUI) police may request a blood alcohol level . NEED consent or evidence wont’ be admissible in court

Chain of Custody

Keeping track of the sample; Maintaining consent and accountability for the test form on patient

• name and identifying information of the subject from whom the specimen was collected

• The name of the person who obtained and processed the specimen

• The date, location, and signature of the person attesting that the specimen is the correct one and matches its documentation

• The signature and date from every Orion that had possession of the specimen for any amount of time, even for transport.