URINE TESTING

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 – cystitis
  • Specific 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 patient
  • Self-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 – 1
  • Match 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
Urine Testing – Purpose, Characteristics, Examination, Preliminary Assessment, Equipment, Procedure, Urine pH, Gravity, After Care

Leave a Comment

Your email address will not be published. Required fields are marked *