URINE COMPOSITION, COLLECTION, AND PRESERVATION Flashcards
(146 cards)
1
Q
URINE COMPOSITION
[?] water
[?] solutes (~60 grams of total solids in 24 hours)
A
95-97%
3-5%
2
Q
Influenced by dietary intake, physical activity, body metabolism, endocrine functions and even body position
A
URINE
3
Q
INORGANIC COMPONENTS
A
Chloride > Sodium > Potassium
NaCl
Others: sulfate, phosphate, ammonium, magnesium, calcium
4
Q
principal salt
A
NaCl
5
Q
major INORGANIC COMPONENT
A
Chloride
6
Q
ORGANIC COMPONENTS
A
Urea
Uric acid
Hippuric acid
Creatinine
Others: carbohydrates, pigments, fatty acids, mucin, enzymes, hormones
7
Q
(60 to 90%): major organic component
A
Urea
8
Q
Containers
A
- clean, dry, leak-proof, clear
- Disposable
- wide-mouthed with a secure lid, and a wide, flat bottom
9
Q
Labels
A
- patient’s name and identification number
- Date and time of collection
10
Q
Requisitions
- Information on the form must match the information on the [?]
- [?] the specimen is received in the laboratory
A
specimen label
time
11
Q
Urine container capacity
A
- 50 ml capacity
12
Q
Specimen Rejection
- [?] labeled specimens
- Nonmatching labels and [?]
- Specimens contaminated with [?]
- containers with [?] exteriors
- Specimens with [?] quantity
- Specimens that have been [?]
A
Unlabeled or improperly
requisition forms
feces or toilet paper
contaminated
insufficient
improperly transported
13
Q
Specimen Integrity
A
within 2 hours
14
Q
Physical, chemical and microscopic characteristics of urine specimen begin to change as soon as the urine is
A
voided
15
Q
Specimen Preservation: Increased
A
- pH
- Bacteria
- Odor
- Nitrite
16
Q
Specimen Preservation: Decreased
A
- Clarity
- Glucose
- Ketones
- Conjugated bilirubin
17
Q
Specimen Preservation: Modified
A
Color
18
Q
Urea——(urease)—- > Ammonia
A
Increased pH
Increased Odor
19
Q
Multiplication
A
Increased Nitrite (nitrate-reducing bacteria)
Increased Bacteria
Decreased Clarity
20
Q
Precipitation of amorphous materials
A
Clarity
21
Q
Glycolysis and bacterial use
A
Decreased
22
Q
Volatilization
A
Decreased Ketones
23
Q
Light exposure
A
Decreased Conjugated bilirubin
24
Q
Oxidation or reduction of metabolites
A
Modified Color
25
Oxidation to urobilin
Decreased Urobilinogen
26
Disintegrates in ALKALINE urine
Decreased Casts
27
Loss of motility: death
Decreased Trichomonas
28
TYPES OR PRESERVATION
1. PHYSICAL
2. CHEMICAL
29
REFRIGERATION
PHYSICAL PRESERVATION
30
↓ Bacterial growth and metabolism
↑ Specific gravity
REFRIGERATION
31
Precipitation of Amorphous phosphates and urates
REFRIGERATION
32
REFRIGERATION TEMP
2C - 8C
33
Does not interfere with chemical tests
Refrigeration
34
Increases SG by hydrometer
Refrigeration
35
Precipitates amorphous substances
Refrigeration
36
Prevents bacterial growth for 24 hours
Refrigeration
37
Preserves glucose and sediments well
Thymol
38
Interferes with acid precipitation test for CHONS
Thymol
39
Preserves CHONS and formed elements well
Boric acid
40
Does not interfere with routine analyses other than pH
Boric acid
41
May precipitate crystals when used in large amounts
Boric acid
42
Keeps pH about 6.0
Boric acid
43
Bacteriostatic at 18g/L; may be used for culture transport
Boric acid
44
Excellent sediment preservative
Formaldehyde
45
Reducing agent, interferes with chemical tests for glucose, blood, LE, and Copper reduction
Formaldehyde
46
Rinse specimen container with formalin to preserve
Formaldehyde
47
Does not interfere with routine tests
Toluene
48
Floats on urine surface; clings to glass wares
Toluene
49
Prevents glycolysis; good preservative for drug analysis
NaF
50
Inhibits reagent strip tests for glucose, blood and leukocytes
NaF
51
May use Na benzoate instead of fluoride for reagent strip testing
NaF
52
Does not interfere with routine tests
Phenol
53
Causes odor change
Phenol
54
Use 1 drop per ounce of specimen
Phenol
55
Preserves cellular elements
Saccomanno (50% ethanol + 2% carbowax)
56
Used for cytology studies (50 mL urine)
Saccomanno (50% ethanol + 2% carbowax)
57
Convenient when refrigeration is not possible
Commercial tablet preservatives
58
May contain one or more of the preservatives including NaF
Commercial tablet preservatives
59
Check tablet composition to determine possible effects on desired test
Commercial tablet preservatives
60
Contains collection cup, C&S preservative tube or UA tube
Urine Collection Kits
61
Sample stable @ RT for 48 hrs; bacteriostatic
Gray C&S tube
62
Decreases pH; do not use if urine is below min fill line
Gray C&S tube
63
Boric acid is the preservative and may not be used for UA
Gray C&S tube
64
Used on automated instruments
Yellow plain UA tube
65
Must refrigerate within 2 hours
Yellow plain UA tube
66
Round/conical bottom
Yellow plain UA tube
67
Stable for 72 hours at RT; instrument compatible
Cherry red/yellow top tube
68
Bilirubin and urobilinogen may be decreased if specimen is exposed to light and left at RT
Cherry red/yellow top tube
69
Na propionate is the preservative
Cherry red/yellow top tube
70
METHODS OF URINE COLLECTION
1. Bottle Method
2. Plastic Bag with Adhesive
3. Urethral Catheterization
4. Suprapubic Aspiration
71
most-commonly used method; performed via midstream clean catch
1. Bottle Method
72
for pediatric patients
2. Plastic Bag with Adhesive
73
catheter is inserted up to the urinary bladder or ureter
3. Urethral Catheterization
74
collected via external introduction of a needle through the abdomen and into the bladder
4. Suprapubic Aspiration
75
Routine screening
Random specimen
First Morning Specimen
Midstream CleanCatch Specimen
76
Pregnancy tests
First Morning Specimen
77
Orthostatic protein
First Morning Specimen
78
Diabetic screening/monitoring
Second Morning Specimen (Fasting Specimen)
2-hour Post Prandial Specimen
79
Urobilinogen testing
Afternoon specimen
Early Afternoon specimen (2-4pm)
80
Addis Count (Sediments)
12-hour urine sample
81
Quantitative chemical tests
24- hour (Timed) Specimen
82
Accompaniment to blood samples in glucose tolerance test
Glucose Tolerance Specimen
83
Bacterial culture
Catheterized Sample
Midstream CleanCatch Specimen
Suprapubic Aspiration
84
Cytology
Suprapubic Aspiration
85
Prostatic infection
3- glass collection
86
- Ideal specimen for routine UA and Pregnancy test
First Morning Specimen
87
- Concentrated, most acidic: for well preservation of casts
First Morning Specimen
88
- For evaluation of Orthostatic Proteinuria
First Morning Specimen
89
- 2nd voided urine after a period of fasting
Second Morning Specimen (Fasting Specimen)
90
- For Nitrite determination
4-hour urine
91
- Urine remains in the bladder for at least 4 hours before voiding
4-hour urine
92
By Thomas Addis(1926)
Addis count
93
Quantitates formed elements in a 12-hour overnight urine collection
Addis count
94
used primarily to monitor the course of diagnosed cases of renal disease
Addis count
95
Addis count
Casts:
RBC:
WBC:
Casts: >5, 000
RBC: >500, 000
WBC: >2,000,000
96
First specimen voided.
First Morning Specimen
97
Most ideal specimen for screening/ testing
First Morning Specimen
98
Most concentrated specimen.
First Morning Specimen
99
Essential specimen for pregnancy test and orthostatic/ lordotic proteinuria
First Morning Specimen
100
Second voided specimen after a period of fasting.
Second Morning Specimen (Fasting Specimen)
101
Best specimen for glucose monitoring.
Second Morning Specimen (Fasting Specimen)
102
Specimen collected after 2 hours of eating.
2-hour Post Prandial Specimen
103
Specimen used for monitoring insulin therapy in patients with DM.
2-hour Post Prandial Specimen
104
Glucose result from this specimen is compared with 2PPBS.
2-hour Post Prandial Specimen
105
Begins and ends with an empty bladder; requires preservative depending on the test to be performed
24- hour (Timed) Specimen
106
Most commonly requested for urine specimen for bacterial culture.
Catheterized Sample
107
Used to measure functions in the individual kidneys
Catheterized Sample
108
Safer, less traumatic specimen that is suitable for routine urinalysis and bacterial culture.
Midstream CleanCatch Specimen
109
Females: separate the skin folds
Midstream CleanCatch Specimen
110
Collected directly from the urinary bladder.
Suprapubic Aspiration
111
For bacterial bladder urine culture.
Suprapubic Aspiration
112
Also used for cytologic examination
Suprapubic Aspiration
113
Specimen used for the detection of prostatic infection.
3- glass collection
114
1st glass sample-
- first urine passed
115
2nd glass sample-
- midstream portion
116
3rd glass sample-
- prostate massage, remaining urine
117
Urine after prostatic massage
Examine the 1st and 3rd specimen microscopically, then compare the number of WBC and bacteria
3- glass collection
118
in the number of WBC and bacteria in the 3rd specimen is 10x greater than that of the 1st specimen
Prostatic Infection=
119
= CONTROL for bladder and kidney infection. If (+) for WBCs and bacteria, the result from the 3rd specimen is INVALID
2nd Specimen
120
-tested for urethral infection or inflammation
VB1
121
-tested for urinary bladder infection
VB2
122
- cultured and examined for white blood cells(>10-20 WBCs/HPF is considered abnormal)
EPS
123
- postprostatic massage urine specimen
VB3
124
Clean-catch midstream urine is collected
PPMT(PRE AND POSTMASAGE TEST)
125
Second urine is collected after the prostate is massaged
PPMT(PRE AND POSTMASAGE TEST)
126
Positive result: >10 x the premassage count
PPMT (PRE AND POSTMASAGE TEST)
127
Specimen collected from pediatric patients.
Pediatric Specimen
128
Uses weebag, a soft, clear plastic bag with adhesive, for collection.
Pediatric Specimen
129
soft, clear plastic bags with hypoallergenic skin adhesive to attach to the genital area of both boys and girls
Pediatric Specimen
130
: process that provides documentation of proper sample identification from the time of collection to the receipt of laboratory results.
- Chain of Custody
131
- Required volume: 30-45 ml
Drug Specimen
132
Drug Specimen
- Temperature (within 4 minutes):
Drug Specimen
32.5-37.7°C
133
- Bluing agent is added to the toilet water reservoir to prevent specimen adulteration
Drug Specimen
134
- At least 2 voided collection
Fractional Specimen
135
- Series of blood and urine samples are collected at specific time intervals to compare concentration of a substance in urine with its concentration in the blood (diagnosis of diabetes)
Fractional Specimen
136
Specimens collected anytime of the day
Random specimen
137
Most commonly received specimen in the laboratory.
Random specimen
138
Useful for routine screening tests to detect obvious abnormality
Random specimen
139
It is the total daily urine output.
24- hour (Timed) Specimen
140
Used for quantitative urine testing.
24- hour (Timed) Specimen
141
Begins and ends with an empty bladder
24- hour (Timed) Specimen
142
If placed in 2 containers, mixed the urine samples well first before aliquoting
24- hour (Timed) Specimen
143
Urine Creatinine determination
24- hour (Timed) Specimen
144
4-aminobenzoic acid (gold standard)
24- hour (Timed) Specimen
145
24- hour (Timed) Specimen
o Adult -
o Less than 1 year old -
o 1 to 14 years old -
600-2000 mL/ 24 hours
100-500 mL/ 24 hours
500-1400 mL/ 24 hours
146
Specimen for used to check for the ability of the kidney to metabolize a measured amount of glucose.
Correlated with renal threshold.
side by side specimen with OGTT.
Glucose Tolerance Specimen
