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Flashcards in Intro to Urinalysis II Deck (51):
0

In measuring specific gravity by reagent strip, when urine pH is > or equal to 7.0 add ______ to the strip reading if it is being read manually

0.005

1

Is there interference from glucose, protein, or radiographic dyes when measuring specific gravity by reagent strip?

NO

2

What is the specific gravity of the filtrate as it leaves the glomerulus?

1.010

3

This term is used to describe urine with a specific gravity of 1.010

isosthenuria

4

This term is used to describe urine with a specific gravity of <1.010

hyposthenuric

5

If a urine is constantly <1.010 (hyposthenuric) what does this represent?

the kidney's inability to concentrate urine, diabetes insipidus, renal disease

6

What does urine with a specific gravity constantly >1.010 represent?

adrenal insufficiency, congestive heart failure, hepatic disease, dehydration

7

What is the physiological limit of specific gravity?

1.040, could be due to radiographic dyes

8

Low fluid intake = _____ specific gravity

High

9

high fluid intake = ____ specific gravity

low

10

If the specific gravity is greater than 1.035 what should you do?

make a 1:2 dilution with distilled water and multiply all digits to the right of the decimal by your dilution factor

11

this is the measure of the concentration of dissolved particles in a solution expressed in osmoles of solute particles per kg of solvent

osmolality

12

osmolality only measures dissolved particles, thus _____ and ______ are not measured

lipids and protein

13

Reference range for specific gravity

1.003 to 1.030

14

Reference Range for urine color

colorless to yellow

15

Reference Range for Urine volume

600-2000 mL/day

16

What does a specific gravity of 1.003 represent ?

Usually a diluted urine

17

What causes changes in urine volume in pathologic states?

solute diuresis in diabetes mellitus

18

What causes changes in urine volume in non-pathologic states?

fluid intake, vomiting, diarrhea, sweating, variation in secretion of ADH, water loss, medications, diuretic therapy, caffeine, alcohol

19

This term is used when describing urine output <400mL/24hrs; decreased volume is due to excess water loss

oliguria

20

this is known as the cessation of urine flow

anuria

21

this is increased volume of urine at night, caused by renal failure

nocturia

22

this is known as increased daily urine volume, caused by diabetes mellitus, diabetes insipidus, medications, diuretic therapy, caffeine, and alcohol

polyuria

23

List the proper criteria for a good specimen (3 things)

1 proper patient ID (name, location, physician, collection date, collection time, test requested)
2 Fresh collection (should be tested within two hours after collection)
3 If testing delayed urine should be refrigerated

24

this technique requires no preparation; good for screening; not good for urine cultures

routine

25

technique often used with random specimens; good for urine culture and routine analysis; noncompliance in collection technique; difficult for some patients to collect

clean catch midstream (CCMS)

26

specimen good for urine cultures and routine analysis; can enter the bladder or either of the ureters and provide information about each kidney independently; can cause UTIs; can cause discomfot in patients

Catheterization

27

involves collecting urine directly from the bladder by puncturing the abdominal wall with a needle and a syringe; usually performed for bacterial cultures (especially anaerobes); used on infants when specimen contamination is unavoidable; sterile but invasive

suprapubic aspiration

28

what testing Is a pediatric urine collection bag used for?

for screening purposes, not for urine culture because of contamination

29

This urine requires no preparation, can be collected anytime, used for routine screening and to detect disease processes, affected by variances in fluid intake and exercise

random urine

30

this urine is collected as soon as waking up, ideal for testing specimens that require concentration and incubation (nitrates, protein, bacteria), confimation of orthostatic proteinuria, formed elements more stable, cells have better morphology, more epithlial cells for cytology studies

First morning urine

31

What is a disadvantage of a first morning urine?

additional crystals may precipitate upon cooling, specimen must be preserved if not tested within 2 hours

32

In this type of collection the goal is to eliminate metabolites from food ingested prior to the beginning of the test, often used for glucose monitoring for patients with diabetes mellitus or gestational diabetes

fasting urine

33

This type of urine requires the patient to void immediately before eating and the collect urine 2 hours post eating; used for diabetes mellitus monitoring; also known as a fractional collection

2 hour postprandial

34

this type of urine collection is used because of circadian and diurnal variations in hormones, proteins, glomerular filtration rates, exercise, hydration, etc; usually 12 or 24 hour collection; preservative is usually in the bottle before patient takes it home

Timed

35

When measuring a urine's specific gravity using a reagent dipstick, are you required to correct for elevated urine glucose?

NO, the reagent strip is not affected by elevated glucose levels

36

pH ________ (increases/decreases) due to decomposition of urea to ammonia and loss of CO2 as a specimen is allowed to sit out, unpreserved

increases

37

glucose is _______ (increased/decreased) due to bacterial consumption as a urine is allowed to sit.

decreased

38

Ketones ______ (increase/decrease) due to bacterial action and will vaporize as a urine is allowed to sit

decrease

39

Bilirubin _____ (increases/decreases) due to photo-oxidation as it sets out

decreases

40

Urobilinogen _______ (increases/decreases) due to oxidation to urobilin

decreases

41

Nitrites _______ (increase/decrease) due to bacterial production

increase

42

If urines are left unpreserved what 3 structures are affected?

RBCs and WBCs degrade, Casts degrade, and bacteria increase

43

What is the most common method of preservation?

refrigeration at 4-6*C, REMEMBER allow urine to reach room temp before testing

44

What is a disadvantage of refrigerating urine?

precipitation of amorphous urates and phosphate crystals that interfere with microscopic analysis

45

Culture of a refrigerated specimen is preferred in ___ Hours but will be accepted up to ___ Hours

8 hours, 24 hours

46

Culture on an unrefrigerated specimen must be performed within ___ Hours post collection

2 hours

47

commonly used preservative for 24 hour urines, preserves protein and formed elements, bacteriostatic/not bactericidal so can be used for culture, precipitates out crystals, decreases pH, interferes with drug and hormone analysis

Boric acid

48

preservative that is an excellent cell preservative, interferes with glucose, blood, leukocyte esterase, and copper reduction testing (clinitest)

formalin

49

preserves sediments such as cells and casts

mucolexx

50

this preservative does not interfere with most chem tests, prevents contamination from only airborne bacteria, does not prevent proliferation of bacteria already in specimen and floats on the surface

toluene