Transcript URINALYSIS

URINALYSIS
URINARY SYSTEM
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Kidneys
Ureters
Bladder
Urethra
URINE COMPOSITION
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Water
Nitrogenous Waste
Mineral Salts
Pigments
STANDARD PROCEDURE
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Collection
Container
Storage
Qualitative vs Quantitative
URINE SPECIMEN COLLECTION
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Random or Spot
Fasting
First Morning
Postprandial Specimen
Midstream
Clean-catch
Timed (24 hour)
PHYSICAL CHARACTERISTICS
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Appearance
Color
Odor
Quantity
Specific Gravity
CHEMICAL
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Reaction (pH)
Protein
Glucose
Ketone
Bilirubin
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Blood
Nitrite
Urobilinogen
Leukocytes
Specific gravity
MICROSCOPIC
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Red Blood Cells
White Blood Cells
Epithelial Cells
Casts
Bacteria
Yeast and Parasites
Spermatozoa
Terminology
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Anuria
Oliguria
Polyuria
Dysuria
PURPOSE OF CATHETERS
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Drain, irrigate or instill meds
Assist incontinent patients
Help begin bladder retraining
Keep bladder empty while surrounding
tissues heal after surgery
Diagnose disease, malfunction, or injury
CATHETERS
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Indwelling (Foley) catheter
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Alcock catheter
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Double lumen with balloon to be filled with
distilled water
Third lumen for irrigation
Straight Catheter
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Single lumen
SIZES
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Female – 1.5-2 inches in length
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Male – 5.5-7 inches in length
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14F-16F
16F-20F
Smaller number, smaller lumen
TRANSPORT
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Keep drainage bag below bladder
Drainage tubing must be coiled and
resting on patients legs or hooked on
chair.
If bag must be lifted, be sure to clamp
tubing to bag, not catheter.
ALTERNATIVE METHODS
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Suprapubic catheter
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Placed directly into bladder through abd
Used to divert flow from urethra due to
surgeries, obstructions, loss of bladder
control, etc
Condom catheter
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Externally applied and for those prone to
urinary tract infections.
Changed every 24-48 hours
CYSTOGRAPHY
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Using fluoroscopy and radiography to visualize
the bladder as it fills and empties.
Cystourethrography –bladder and urethra
Voiding cystography – pt’s ability to empty
bladder
Voiding Cystourethrography – urethra
studied as pt voids upon removal of catheter
RETROGRADE PYLOGRAPHY
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To visualize proximal ureters and kidneys
after injection of contrast.
Performed in cystoscopy suite with
urologist
Assesses ureters for obstruction
Stents may be placed due to stricture,
edema or tumors