Analysis of urinary & bodily fluids
LABORATORY
TYPES OF COMMON URINE SPECIMENS
RANDOM
• Routine screening
• May require confirmatory testing based o;n diet and
exercise
FIRST MORNING
• Collected immediately on arising
• Routinely screening/confirmatory testing
• Orthostatic proteinuria
• Pregnancy tests
MIDSTREAM CLEANCATCH
CHANGES IN UNPRESERVED URINE
• Requires patient to cleanse the genital area
• Void first into the toilet, then collect specimen and INCREASED RESULTS
Finnish voiding into the toilet
• Bacterial cultures • pH
• Nitrite
CATHETERIZED • Bacteria
• Collected from the catheter passed into the bladder DECREASED RESULTS
• Bacterial cultures
• Note: when a routine urinalysis and a culture are both • Glucose: glycolysis
ordered, perform the culture first • Ketones: oxidation
• Bilirubin: oxidation to biliverdin
24 HR (TIMED) • Urobilinogen: oxidation to urobilin
• Patient voids into the toilet and then begins timing
• Collects all urine during the designated period
• Voids and collects urine at the end of the period
• Specimens can provide the quantitative results
DRUG SCREENING
• Strictly follow chain-of-custody from requirements
PRESERVATION OF URINE SPECIMENS
• Test specimens within 2 hours of collection
• Refrigerate specimens that cannot be tested within 2
hours
FIRST MORNING SPECIMEN
URINE VOLUME
7AM – WAKE UP • Normal: 600 to 2000ml/day
7:15 – FIRST URINATE – VOID • Oliguria: decreased output, less than 400ml/day
7:30 – COLLECTED • Anuria: no urine output
7: 15 (NEXT DAY) – URINE TO BE • Nocturia: increased urine output greater tgab 2.5L/day
COLLECTED
• Polyuria: increased urine output greater than 2.5 L/day
▪ Diabetes mellitus: increased urine output to
excrete excess urine glucose
▪ Diabetes insipidus – increased urine output
caused by lack of dysfunction of antidiuretic
hormone (ADH) – results in polydipsia
NAME 1
TRANS: Module 1
SPECIMEN COLLECTION AND HANDLING
1. The actual date and time of specimen collection
2. Whether the specimen was refrigerated before
transporting
3. The time the specimen was received In the laboratory
and the time the test was performed
4. Tests requested
5. An area for specific instructions that might affect the
results of the analysis
6. Patient identification information. The patient’s sex,
age or date of birth, and then the appropriate, the
source of the specimen and the time it was collected
must be documented
CONTAINERS
• Must be collected in clean, dry, leak-proof containers.
Properly applied screw-top lids are less likely to leak
than are snap on lids
• Containers for routine urinalysis should have a wide URINE CLARITY
mouth to facilitate collections from female patients and • Terminology: clear, hazy, cloudy, turbid, milky
a wide, flat bottom to prevent overturning • Freshly voided normal urine is clear
• The recommended capacity of the container is 50ml, • Refrigerated normal urine
which allows 12ml of specimen needed for microscopic • White turbidity in urine with an alkaline ph from
analysis, additional specimen for repeat analysis, and amorphous phosphates and carbonates
enough room for specimen to be mixed by swirling the • Pink turbidity in urine with an acid pH from amorphous
container. urates
NON PATHOGENIC TUBRIDITY
• Squamous epithelial cells
• Mucus
• Amorphous phosphates, carbonates, and urates
• Semen
• Feces
• Radiographic contrast media
• Powder and creams
PATHOLOGIC TURBIDITY
• Red blood cells
• White blood cells
• Yeast
• Urothelial and renal tubular epithelial cells
• Abnormal crystals lipids (milky)..
SPECIFIC GRAVITY
• Screening tests for renal tubular reabsorption for
essential elements filtered by the glomerulus
• Based on the fact that the glomerular filtrate has a
specific gravity of 1.010
• Urine contains dissolved substances that produce
density by their size and number
REAGENT STRIP
• Primarily test for routine urinalysis
• Principle based on the number of hydrogen ions
released from a polyelectrolyte is proportional to the
number of ions in the urine
• Increased urine concentration=increased H+
released=low PH
• The indicator on the strip is bromothymol blue
• Reaction= yellow green (acid) green blue (alkaline)
REFRACTOMETER
• Principle: the concentration of dissolved particles in a
URINE COLOR solution determines the velocity and the angle of light
• Normal urine is yellow, shades of yellow are based on passing through a solution
fluid consumption and vary from pale yellow (dilute) to • The refractometer uses a prism to direct a wave length
dark yellow (conccentrated) of light though the urine; the angle of the light can be
read on a scale calibrated with distilled water (1.000)
NAME 2
TRANS: Module 1
ODOR
• Although it is a seldom clinical significance and is not a
part of the routine urinalysis, urine odor is a noticeable
physical property. Freshly voided urine has a faint
aromatic odor. As the specimen stands, the odor of
ammonia becomes more prominent.
NAME 3
