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Lab Dx Lab - I > Week 1 > Flashcards

Week 1 Flashcards

(80 cards)

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0
Q

On a female, what should be wiped with the first and second towelette? Which direction? How many swipes?

A
  • One side of the labia minora (inner fold)
  • Downward stroke
  • Single swipe
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1
Q

For mid-stream urine collection, how many moist towelettes should be used prior to collection?

A

3

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2
Q

On a female, what should be wiped with the third towelette? Which direction? How many swipes?

A
  • Cleanse meatus (center area)
  • Downward stroke
  • Single swipe
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3
Q

Why is the mid-stream urine collection method used?

A

Minimize epithelial tissue and genital secretions

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4
Q

T/F: A urine cup with separate lid is considered sterile until used by a patient.

A

FALSE! A cup that comes separate from the lid is NOT sterile. Only cups with lids attached with a sticker are considered sterile.

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5
Q

How long is a urine specimen viable?

A

1 hour on the counter, 4-6 hours if refrigerated

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6
Q

How is refrigerated urine re-warmed after refrigeration?

A

Water bath

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7
Q

How much urine is required to complete a test?

A

10-12mL

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8
Q

What is the leading reason for UA? Second?

A
  • UTI

- Kidney stones

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9
Q

What information should be written on a specimen?

A
  • Patient name
  • Date of collection
  • Time of collection
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10
Q

When must a sterile container be used to collect urine?

A

When ordering a urine culture

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11
Q

Under what circumstances can a urine sample last longer than normal? Why? How long can it last?

A
  • When using a urine culture transport kit, because it contains preservatives.
  • 48 hours
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12
Q

What characteristics are we looking for during macroscopic examination of urine?

A
  • color
  • clarity
  • amount
  • strong or unusual odor
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13
Q

Why might it be important to list out the different tests being run from a urine dipstick prior to beginning the test?

A

Different reagents need to be read at different times, listing them out prior makes recording result quicker, thus more accurately recorded results.

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14
Q

How long should a dipstick be submerged in urine to get an accurate test?

A

No more than 1 second

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15
Q

When should timing of the results begin?

A

After the dipstick (all the reagent squares) has been submerged, it should be pulled out on the edge along the rim of the specimen cup to rid excess urine and then placed upon a paper towel. Begin timing immediately.

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16
Q

What is normal coloring for urine?

A

Pale to deep yellow

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17
Q

What would excessively pale urine indicate?

A

Dilute urine due to metabolic causes such as DM, DI, diuresis

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18
Q

What would red pigmented urine indicate? (5 things)

A
  • Presence of blood
  • Presence of hemoglobin
  • Presence of myoglobin
  • Porphyrinuria
  • Eating a lot of beets
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19
Q

What would brown/black urine indicate? (4 things)

A
  • Blood
  • Alkaptonuria
  • Melanoma
  • Flagyl
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20
Q

What does deep amber coloring of urine indicate? (2 things)

A
  • Hepatitis

- Bile pigments

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21
Q

What would yellow/green urine indicate the presence of?

A

-Biliverdin (oxidized bilirubin)

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22
Q

What would orange urine indicate?

A

Presence of pyridium (an analgesia used to treat UTI)

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23
Q

What would blue/blue green urine indicate?

A
  • Methylene blue

- Some drugs

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24
What would bright yellow urine be indicative of?
Presence of riboflavin
25
What things (6) could be the cause of cloudy urine?
- WBCs - Epithelial cells - Bacteria - Mucous - Fat - Amorphous crystals
26
Which test/reagent will vary with diet, drugs, and disease?
pH
27
T/F: pH test will show more alkaline with UTIs and renal disease
True
28
What is the correct range for normal pH? What is it usually?
4.8-7.5, usually 5.0-6.0
29
What is the normal response range for the protein reagent?
Negative to trace
30
What are some things that could cause a false positive for protein?
- Exercise - Stress - Fever
31
What are some true reasons for a positive protein test?
- Renal glomerular disease - CHF - Multiple myeloma - Pre-eclampsia - DM - Amyloidosis
32
What substance is a protein test sensitive to?
Albumin, not globulins
33
What would cause a false positive for protein?
Urine pH >8.5
34
What is the normal range for the specific gravity reagent?
1.003-1.025
35
What would cause the specific gravity to decrease?
- DI - Collagen disease - Pyelonephritis - Malnutrition
36
What would cause the specific gravity to increase?
- DM - Presence of protein - Presence of fat - X-ray dyes
37
T/F: It is normal to have some glucose in the urine
FALSE!!! Glucose should NOT be in urine!
38
At what blood level does glucose begin to spill into urine?
>160mg/dl - 180mg/dl
39
What things would cause a positive glucose test?
- DM - Gestational Diabetes - Pancreatic disease - Renal tubular disease - Cushing's Syndrome
40
What would cause a false negative for glucose in the urine?
- High dose vitamin C - Cephalosporins - Ketonuria - If GFR is very low in DM
41
What would cause a false positive for glucose in the urine?
Phenylketones
42
What should a normal response be for the ketone reagent?
Negative
43
What are ketones?
Byproducts of fatty acid metabolism
44
What things would produce ketones in urine?
- Diabetic ketoacidosis (more common in Type 1) - Fever - Fasting/Starvation - Prolonged vomiting or diarrhea - Thyrotoxicosis - Alcoholism - Low CHO - High protein diets
45
What could cause a false negative for ketones?
Old urine not tested within the time limits
46
What could cause a false positive for ketones?
- Phenylketones | - Levodopa metabolytes
47
What is the normal response for blood/hemoglobin reagent?
Negative
48
How do intact RBCs appear on the blood/hemoglobin reagent? Ruptured RBCs?
Intact: speckled Ruptured: solid
49
What would cause a blood/hemoglobin test to be positive?
- UTI - Renal disease - Bladder CA - Kidney stones - Coagulation disorders - Right CHF - HTN - Trauma - Leukemia - Intravascular hemolysis
50
What would cause a false negative for blood/hemoglobin?
High dose vitamin C
51
What would cause a false positive for blood/hemoglobin?
Myoglobinuria
52
What is the normal result for bilirubin reagent?
Negative
53
How is bilirubin formed?
Formed from the degradation of hemoglobin
54
What would cause a positive result for bilirubin in urine?
- Build-up of conjugated bilirubin due to hepatocellular disease - Posthepatic obstructive jaundice
55
What would cause a false negative for bilirubin?
- High dose vitamin C | - Prolonged exposure to light
56
What would cause a false positive for bilirubin?
- Pyridium | - Chlorpromazine
57
What is the normal response for the urobilinogen reagent?
Negative to trace
58
How is urobilinogen formed?
Formed from bilirubin by intestinal bacteria
59
What would cause a positive result for urobilinogen?
- Hemolytic anemia - Some hepatocellular diseases - CHF - Hepatitis - Bowel obstruction or toxicity
60
What would cause a false negative for urobilinogen?
- Prolonged exposure to light - Formaldehyde - Antibiotics
61
What would cause a false positive for urobilinogen?
- Phenylpyridine - PABA - Azo dyes
62
What is the normal response to nitrites reagent?
Negative
63
What percentage of bacteria are nitrite producers?
20%
64
What are nitrites? What must be present in order for bacteria to produce nitrities?
Byproduct of bacterial metabolism; nitrates
65
T/F: A negative finding can rule out a UTI
FALSE!!! A negative finding does NOT rule out UTI!
66
What would cause a positive result of nitrites?
UTI with bacteria capable of converting NO3 ---> NO2 | E.coli, Enterobacter, Pseudomonas
67
What would cause a false negative for nitrites?
- High dose vitamin C - High specific gravity - Low nitrate diets - Urine in bladder < 4 hours
68
What would cause a false positive for nitrites?
- Bacterial growth in old urine sample - Pyridium - Pigment from beets
69
What is a normal response for WBCs/Leukocytes reagent?
Negative to trace
70
What would cause a positive response for WBCs/Leukocytes?
- Infection or irritation of the urinary tract | - Kidney stones
71
What would cause a false positive for WBCs/Leukocytes?
- High dose vitamin C - Trichomonas - Heavy mucous - Vaginal contamination
72
Where is blood usually drawn from?
Antecubital fossa of the arm
73
Why do we draw blood from the antecubital fossa?
Easier access to larger veins that are generally easier to visualize and palpate.
74
What 2 noteworthy structures run in the antecubital fossa?
- Biceps tendon | - Median nerve
75
What are other appropriate areas from which to draw blood?
- Forearm - Wrist - Back of hand
76
In order to be effectively evaluate the status of a vein, a tourniquet must be placed ___-___ inches above the antecubital fossa.
2-3 inches
77
Do NOT leave the tourniquet on the arm for longer than ___ minutes. Why?
3; venous stasis and altered lab results
78
When looking for a vein for a blood draw, how should the vein feel?
large and rubbery, and easily bounce back when compressed
79
What are some tricks that can be useful in maximizing chances of a successful blood draw?
- Hydration - Heat area for 10-15 minutes - Have pt. hang arm below heart level for 60 seconds - Stroke finger up and down the course of the vein

Lab Dx Lab - I (2 decks)

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