Diagnostics tests

Diagnostic Tests of the Urinary System

• Clients may present with urinary findings indicating issues with the urinary tract.

• Common symptoms of urinary tract infections (UTIs) may include:

  • Urinary leaking

  • Increased frequency of urination

  • Painful urination (dysuria)

  • Urgency to urinate

  • Difficulty starting urination

  • Incomplete bladder emptying

Importance of Diagnostic Testing

• Health care providers may recommend diagnostic testing when symptoms such as dysuria occur, often due to infection or injury.

• Urodynamic Testing:

  • Evaluates how the bladder, sphincters, and urethra hold and release urine.

Types of Diagnostic Tests

• Urothalometry:

  • Measures urine flow speed and volume.

• Postvoid Residual Measurement:

  • Measures amount of urine left in the bladder after voiding.

• Systemometric Test:

  • Measures bladder capacity and pressure during filling and urgency to urinate.

• Leak Point Pressure Measurement:

  • Measures bladder pressure at the start of leakage.

• Electromyography (EMG):

  • Calculates electrical impulses of bladder and sphincter nerves and muscles.

• Video Urodynamic Tests:

  • Takes images/videos of the bladder during filling/emptying.

• Cystoscopy:

  • Uses an optical instrument to view the urethra and bladder lining.

• Ureteroscopy:

  • Uses an optical instrument to observe the ureters and kidneys.

• Pressure Flow Study:

  • Measures pressure needed in the bladder to initiate urination and flow speed.

Urine Specimen Collection

• Urinalysis:

  • A lab test used to evaluate various disorders such as UTIs, kidney infections, kidney disease, and diabetes.

  • Involves:

    • Visual examination of urine (clarity, color, odor)

    • Dipstick testing (chemical analysis)

    • Microscopic examination (looking for cells or crystals)

• Collection Procedure:

  • Nurse must gather supplies, ensure proper labeling, and explain the procedure to the client.

  • A sterile container is necessary, and gloves must be worn.

  • A urinary catheter may be used if needed.

  • Be aware of possible false negatives due to pre-existing antibiotic use.

Urine Culture

• Used to evaluate for bacteria or yeast that cause a UTI.

• Collection involves:

  • Obtaining a clean specimen to avoid contamination.

  • Wiping genitals with sanitary wipe before collecting.

  • Initial urination into the toilet, then into the collection container.

  • Sending the sample to a lab for bacterial growth analysis during incubation.

24 Hour Urine Collection

• Purpose:

  • Evaluates chemical composition and kidney function.

• Procedure Includes:

  • Collecting urine over 24 hours in a special refrigerated container.

  • Avoiding specific foods and medications that may alter results.

  • Client records start time and keeps samples refrigerated between collections.

Methods of Urine Specimen Collection

• Clean Catch Method:

  • Clients clean genital area and collect urine midstream for accuracy.

• Catheterization:

  • Collecting urine via catheter requires sterile technique to avoid infection.

  • Follow up with proper procedures for catheter insertion and management.

Travel and Water Contamination Risks

• Recent travels outside of the U.S. may expose clients to contaminated water sources.

• Infections can occur from bacteria leading to severe diarrhea.

• Risk factors include:

  • Contaminated food/drink:

    • Eating raw or undercooked eggs or meat.

    • Consuming unpasteurized milk.

    • Drinking untreated water from lakes or streams.

• Prolonged antibiotic use may necessitate an investigation for fecal bacteria.

Stool Culture Preparation

• When a stool culture is ordered, the nurse educates the client on specimen preparation.

• Key Points for Stool Specimen Preparation:

  • Unlike FOB tests, no dietary or medication restrictions are required.

  • Clients will receive necessary collection supplies, including:

    • Collection container for use in the toilet.

    • Collection spatula (e.g., tongue depressor or spoon).

    • Test container, labels, and mailing containers.

  • Specimen Collection Process:

    • Place the collection container in the toilet before a bowel movement.

    • Produce the bowel movement into the container.

    • Use collection spatula to transfer the sample into the test container.

    • Affix necessary labels to the specimen container.

    • Place the specimen in the mailing container for lab analysis.

• Lab Analysis:

  • Samples are analyzed for the presence of infectious bacteria.

  • Results typically available in a few days.

Follow-Up Testing

• Depending on stool culture results and client manifestations:

  • Further testing may be required, such as:

    • Ova and parasite testing to rule out more serious pathogens.

Conclusion

• Proper collection and testing of urine samples are essential for accurate diagnosis and treatment of urinary tract issues.