URINE TESTING Leave a Comment / Nursing Procedure / By nurseinfo.in URINE TESTING Urine analysis methods comprise testing reaction, specific gravity, albumen, sugar, bile, acetone, pus, blood and yeasts microscopically Purpose To detect reaction, in cystitis the reaction is alkaline To detect sugar, it is present in diabetes mellitus To detect – protein it is present in kidney damage, pre-eclampsia and is called proteinuria To detect acetone, it is present due to incomplete metabolism of fat To detect bile – it is seen in cases of obstructive jaundice or hemolytic diseases To detect pus cells – it is present due to urinary tract infection To detect blood – it is seen in snake bite, fracture pelvis, etc Characteristics of Normal Urine Volume: 1,000 to 2,000 ml in 24 hours Appearance: clear Odor: aromatic color Color: amber or pale straw in color Reaction: normal urine is slightly acidic Specific gravity: 1.010 to 1.025 Constituents of the normal urine: water 96 percent, urea 2% and uric acid, urates, creatinine, chlorides, phosphates, sulfates, oxalates – 2% Characteristics of Abnormal Urine Volume Polyuria – increased in volume Oliguria – decreased in volume Anuria – total absence or marked decrease of urine Suppression – failure of the kidney to secrete urine Color Green or brownish yellow – bile salts and bile pigments Reddish brown – urobilinogen Bright red – a large amount of fresh blood Smokey brown – blood pigment Milk white – chyluria due to filariasis Appearance Mucus – appears as a flocculent cloud Pus – settles at the bottom as a heavy cloud Stones – as fine sand Uric acid – as grains of pepper Odor Sweetish or fruity odor – seen in diabetes Reaction Alkaline – cystitisSpecific gravity Diabetes mellitus – increased specific gravity Renal disease – low specific gravity Constituents of urine Kidney damage – albumin Types of Examination of the Urine Physical examination: color appearance, volume, reaction, specific gravity and color Chemical examination: routine tests such as for albumin and sugar. Special tests such as tests for acetone, bile pigments and bile salts. Microscopic examination – crystals, casts, RBC, pus cells, epithelial and bacteria Preliminary Assessment The doctor order for any instructions Articles available in the unit General condition and diagnosis of the patientSelf-care ability of the patient Preparation of the Patient and Environment Explain the procedure to the patient Keep the urine sample ready Arrange the articles ready in the treatment Provide labeled container for collecting urine Equipment Test tubes 4 to 6 on a test tube Test tube holder – 1 Spirit lamp – 1Match box – 1 Kidney tray with lining to discard the wastes Duster or rag piece – to wipe the outside of the test tube before heating Acetic acid – to test urine for albumin Nitric acid or sulfosalicyclic acid – to test urine for albumin Red and blue litmus paper – to test the reaction of the urine Urinometer – to measure the specific gravity of the urine Benedict’s solution – to test urine for sugar Ammonium sulfate crystals, sodium nitroprusside crystals and liquor ammonia to test urine for acetone Weak solution of Tr. Iodine to test for bile pigments Sulfur powder: to test for bile salts Glass jar: to measure the amount of the urine Pipette – 2 – to measure drops of urine and reagents A small bottle brush – to clean the test tubes Procedure Sugar Test Take test tube and fix in holder Pour 5 ml of Benedict’s solution into test tube Light spirit lamp and heat Benedict solution till it boils Holding test tube mouth facing away from nurse Add 8 drops of urine using dropper and allow boiling for few seconds Put off flame and cool test tube under running water Observations Blue: Nil Green: +Yellow: ++Orange: +++Brick red: ++++ Albumin Test A hot test Fill 2/3 of test tube with urine, secure test tube holder at very top Heat the upper third of test tube over flame If there is precipitation, it denotes the presence of wither protein or phosphate Add 2-4 drops of 2 percent acetic acid If precipitate dissolves it is due to phosphates present in normal urine If precipitate does not dissolve it denotes presence of albumin Observation Trace: + Cloudy:++ (100mg/dL) Thick cloudiness: +++ (500 g/dL) Cold Test Pour a small quantity of nitric acid or sulfosalicylic acid 3 percent in to a clean test tube Allow equal quantity of urine to trickle down the sides of the test tube If albumin present, a white precipitate will be seen where two fluids meet Urine pH Collect and keep ready with urine sample Dip litmus strip in urine and keep for one minute Note color change Discard strip into container for infected waste Urine Specific Gravity Fill 3/4 of jar with urine Gently place urinometer into jar When urinometer stops bobbing Read specific gravity directly from scale marked on calibrated stem of urinometer Make sure that instrument floats freely and does not touch sides of jar Read scale at lowest point of meniscus to ensure an accurate reading at eye level Rothera’s Test (Acetone) Take 2 cm depth of ammonium sulfate crystals in a small test tube Add equal volume of urine and one crystal of sodium nitroprusside Close the test tube with a cork and shake the test tube Take liquor ammonia and add it to the urine, trickling through the sides Read the results immediately Observations If acetone is present permanganate purple colored ring is formed at the junction of urine and ammonia Hays Test (Bile Salts) Take a test tube, half full of urine Sprinkle sulfur powder on the surface of the urine If the powder sinks down to the test tube, it indicates the presence of bile salts Smith’s Test (Bile Pigments) Fill 3/4 of test tube with urine Add iodine drops along the sides of the tube, so as to form a layer on the surface of the urine A green color at the junction of the two liquids indicates the presence of bile pigments After Care Discard the urine in the sluice room Wash the test tube with soap and water Dry the tube, holder and urinometer with jar Replace the article after cleaning Wash hands thoroughly Record the procedure in the nurse’s record sheet and dietetic chart Urine Testing – Purpose, Characteristics, Examination, Preliminary Assessment, Equipment, Procedure, Urine pH, Gravity, After Care Post navigation ← Previous PostNext Post → Leave a Comment Cancel Reply Your email address will not be published. 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