Urinalysis

 

Obtainig mid-stream urine (MSU)

1. Use sterile container (men) or tray (women).
2. Advise patient to part labia or pull back foreskin, let 1st bit into toilet, then deviate to pot without hesitation. Close container.
3. Test within 1 hour, or store in fridge then bring back to room temperature for testing.

Use catheter or suprapubic aspiration if there is difficulty obtaining sample.

Urine dipstick procedure

1. Preparation: apron and gloves, timer, and check date on reagent pack.
2. Collect sample, then check name and DOB, and check smell, colour, and clarity.
3. Completely immerse the reagent areas of the strip in urine and remove after 2 seconds, running edge of strip against rim.
4. Hold strip horizontal to prevent mixing of chemicals or contaminating hands with urine.
5. Start timer, and hold strip close to color blocks and match carefully, but avoid laying strip directly and soiling. Correct read time is critical for optimal results.
6. Dispose of strip, gloves, and apron, and document results in notes.

Urine dipstick parameters

• Blood: see haematuria and nephritic syndrome.
• Protein: see proteinuria and nephrotic syndrome.
• Glucose: DM, ↓renal threshold, pregnancy, renal tube damage.
• Ketones: starvation, DKA.
• Leukocytes: UTI, vaginal discharge.
• Nitrites: UTI, ↑protein meal.
• BR: obstructive jaundice.
• Urobilinogen: pre-hepatic jaundice.
• Specific gravidity: 1-1.03 is normal.
• pH: 4.5-8 is normal.

Urine dipstick findings by disease

• Diabetes: glucose, ketones.
• UTI: leukocytes, nitrites, blood, protein.
• Jaundice: BR, urobilinogen (pre-hepatic).
• Kidney disease: blood, protein, ↑pH, ↑specific gravidity.