UA labs

Question 1

what would the nurse expect NORMAL urine to look like?

Answer 1

Light yellow to light amber, typically clear

Question 2

what does turbid urine mean?

Answer 2

Super cloudy

Question 3

which foods could potentially turn your urine pink to red?

Answer 3

Beets, blueberries, or rhubarb

Question 4

what does dark yellow urine indicate?

Answer 4

Dark urine indicates concentrated urine; the patient needs to drink water.

Question 5

what does amber or honey urine indicate?

Answer 5

Your body isn’t getting enough water, drink some now!

Question 6

what does syrup or brown ale colored urine indicate?

Answer 6

You could have liver disease, or severe dehydration. Drink water and see PCP if it persists.

Question 7

what does pink to reddish colored urine indicate?

Answer 7

Possibly from recent ingestion of beets, blueberries, or rhubarb. If not, then could be blood in your urine which could indicate kidney disease, tumors, UTI, prostate problems or something else. Could indicate lead or mercury poisoning. See doctor.

Question 8

what does orange colored urine indicate?

Answer 8

Possible dehydration, but also could be liver or bile duct condition. See doctor.

Question 9

Which labs would we check for with urinary conditions?

Answer 9

• Creatinine-BUN (blood urea nitrogen)
• Potassium
• Calcium
• phosphorus

Question 10

what is a normal creatinine lab value?

Answer 10

0.5-1.2 mg/dL

Question 11

what is the most reliable indicator of renal function?

Answer 11

Creatinine,

BUN can be influenced by fluid status.

Question 12

what is creatinine?

Answer 12

breakdown of muscle & protein metabolism and is released at a consistent rate

Question 13

would creatinine be HIGH or LOW with decreased kidney function?

Answer 13

HIGH! Kidneys are unable to eliminate toxins so they build up.

Question 14

what condition could lead to LOW creatinine?

Answer 14

Muscle atrophy, otherwise a low creatinine is insignificant.
Remember, it’s HIGH with decreased kidney function.

Question 15

what is a normal blood urea nitrogen (BUN)

Answer 15

10-20 mg/dL

Question 16

what are some non-renal factors that can cause a high BUN

Answer 16

• high nitrogen tube feedings/high protein diet
• GI bleeds
• dehydration (false high)

Question 17

what is a normal potassium lab value

Answer 17

3.5-5.0 mEq/L

Question 18

what is the first electrolyte to become abnormal when kidney function is compromised?

Answer 18

K+

Why? b/c the kidneys excrete majority of potassium

Question 19

what would you worry about with a K+ that is GREATER than 6.0

Answer 19

cardiac dysrhythmias

muscle weakness

Question 20

what is a normal calcium lab value

Answer 20

9.0-10.5 mEq/L

Question 21

in kidney disease, would we expect ca to be high or low

Answer 21

low

Question 22

what does low ca in kidney disease cause

Answer 22

renal osteodystrophy -

- leading to potential bone breaks

Question 23

what is the normal phosphorous lab value

Answer 23

3.0-4.5 mEq/L

Question 24

which too electrolytes have an INVERSE relationship

Answer 24

calcium & phosphorus– meaning if ca is low, then phosphorous will be high and vice versa

Question 25

would phosphorous be high or low with kidney disease

Answer 25

high! kidneys are the primary excretors of phosphorous, plus we know that kidney disease causes low ca so due to their inverse relationship this makes sense

Question 26

what is the normal lab value for magnesium

Answer 26

1.3-2.1 mEq/L

Question 27

will magnesium increase or decrease with kidney disease

Answer 27

increase! mg is excreted by the kidneys

Question 28

what urine is BEST for a urinalysis

Answer 28

first morning urine

Question 29

what are normal urinalysis values

Answer 29

``` bilirubin- none color -- amber yellow glucose-- none ketones-- none odor-- aromatic pH 4.6-6.0 proteins-- zero to trace RBCs 0.4/hpf specific gravity 1.010-1.030 WBCs 0.5/hpgf ```

Question 30

what are some urinary diagnostic studies

Answer 30

- creatinine clearance vs. eGFR - bladder scan - urine culture (clean-catch) - cystoscopy - kidney, ureter, bladder (KUB - intravenous pyelogram (IVP) - retrograde pyelogram - renal biopsy - non-contrast spiral CT

Question 31

what does a creatinine clearance show

Answer 31

Approximates GFR (amount of blood filtered per minute by glomeruli)

Question 32

how long do you collect urine for a creatinine clearance?

Answer 32

24 hours discard FIRST urine when beginning testing save all urine for 24 hour sat end of 24 hours, have patient urinate and add to collection check serum creatinine in middle of 24 hour period

Question 33

T/F: 24-hour urine container for a creatinine clearance should be kept at room temperature

Answer 33

False -- refrigerate.

Question 34

T/F: At the end of the 24 hour urine collection the nurse should have the patient void and dispose of this urine.

Answer 34

False-- should add to the 24 hour collection, but yes have them urinate at the end and ADD it.

Question 35

what variables are taken into consideration with an estimated GFR

Answer 35

age, sex, weight, and ethnicity

Question 36

what does a bladder scanner do

Answer 36

calculates presence of residual urine

Question 37

What are the appropriate steps to ensure a urine collection is CLEAN CATCH

Answer 37

1. Wipe from front to back to clean the urinary meatus 2. Pee for 1-2 seconds into the toilet before you begin to collect3. Collect into a sterile container

Question 38

what is the main goal of a cystoscopy

Answer 38

to inspect interior of bladder wall

Question 39

what should the patient expect POST cystoscopy

Answer 39

burning, pink tinged urine & frequency

Question 40

is bright red blood normal after a cystoscopy

Answer 40

NO! pink tinged it ok, but not bright red

Question 41

what is a KUB (kidneys, ureters, bladder)?

Answer 41

an x-ray of abdomen and pelvis

Question 42

do you need a bowel prep for a KUB?

Answer 42

Yes, stool could block what we need to see

Question 43

what should the patient expect anytime contrast dye is used?

Answer 43

a flushed feeling with injection

Question 44

what allergies should you check before contrast dye is used

Answer 44

iodine

Question 45

what should you recommend the patient does after a procedure with contrast dye

Answer 45

push fluids, dye is nephrotoxic

Question 46

do you need a bowel prep for intravenous pyelogram?

Answer 46

yeS! stool could cover what we need to see

Question 47

when would we use a retrograde pyelogram?

Answer 47

if: - IVP doesn't visually adequately - pt allergic to contrast- - b/c here we use contrast but it doesn't get into blood stream - if patient has decreased renal function

Question 48

what is a retrograde pyelogram

Answer 48

a cystoscope and urethral catheter is inserted and looks backwards up through the kidneys

Question 49

what labs should you check prior to a renal biopsy and why?

Answer 49

INR, PT, coags, platelets b/c kidneys are super vascular and high risk of bleeding

Question 50

Post renal biopsy instructions

Answer 50

- apply pressure dressing - keep on affected side for 30-60 min - bedrest 24 hours - vs q 5-10 min x 1 hour-assess for flank pain

Question 51

position for renal biopsy

Answer 51

tilted on table to open up intercostal spaces

Question 52

what is the gold standard for diagnosing renal colic symptoms

Answer 52

non-contrast spiral CTit is quick, non-invasive, and no IV contrast!!