Urinalysis

Question 1

What is urinalysis?

Answer 1

According to the skills for midwifery practice urinalysis is the testing of both the physical characteristics and the composition of freshly voided urine and is undertaken for the purposes of:

• Screening for systemic and renal disease
• Diagnosis:of a suspected condition
• Management and planning:as a baseline and for planning and monitoring care

Question 2

What would you do before obtaining a urine sample?

Answer 2

As part of infection control it is vital to wash hands and don PPE as we are handling bodily fluids. As part of the NMC Code informed consent must be gained prior to obtaining the sample.

Question 3

What are the three things in which we are looking for prior to testing?

Answer 3

Colour

Clarity

Odour

Question 4

What could urine with a sweet odour indicate?

Answer 4

Presence of ketones

Question 5

What can urobilinogen indicate?

Answer 5

Liver abnormalities/excessive haemolysis

Question 6

What does bright red urine indicate?

Answer 6

Bleeding from the bladder

Question 7

What does dark yellow urine indicate?

Answer 7

Dehydration

Question 8

Urine with a fishy/offensive smell may indicate what?

Answer 8

Infection

Question 9

Protein in urine (proteinuria) can indicate what?

Answer 9

Contaminated specimen, renal disease or pre-eclampsia

Question 10

What can nitrates in urine indicate?

Answer 10

UTI (Urinary tract infection)

Question 11

What can glucose in urine (glycosuria) indicate?

Answer 11

Blood glucose levels rise or if renal absorption lowers.

May indicate gestational diabetes or diabetes, can also be a normal physiological process in pregnancy due to glomerular filtration rate

Question 12

What is an MSSU?

Answer 12

Mid-Stream Specimen of Urine

Question 13

What can blood in urine (haematuria) indicate?

Answer 13

May indicate infection, trauma, tumour or calculi. It may be due to contamination from the vagina or haemorrhoids

Question 14

What does green urine indicate?

Answer 14

Pseudomonas infection

Question 15

Ketones in urine (ketonuria) can indicate what?

Answer 15

Excessive breakdown of body fats. This may occur due to fasting,dehydration,vomiting or uncontrolled diabetes

Question 16

Why do we carry out urinalysis?

Answer 16

Non-invasive and reliable for diagnosing signs and symptoms of diseases in early stages.

Enables monitoring of well-being and deviations from the norm.

Question 17

What does very dark/yellow/brown urine indicate? (Maybe frothy too)

Answer 17

Bilirubinuria (condition of the liver)

Question 18

What is a regency stick?

Answer 18

Are dip sticks that are used to dip into urine to determine whether the urine sample if normal, or contains characteristics so that a diagnosis can be given

Question 19

Explain how you would test a specimen of urine?

Answer 19

Ensuring hands are washed and PPE is worn.

1) Observe the colour, clarity and odour of the urine first
2) Ensure the regency stick is within date
3) Insert the stick into the urine so it is fully submerged
4) Quickly pull it out so that the colours on the stick do not run
5) Place the stick next to the bottle of regency sticks to interpret results
6) Dispose or urine correctly
7) Document findings
8) If any concerns with the urine have been recognised these must be sent off to pathology for further testing
9) Discuss the findings with woman and answer any questions to which she may have

Question 20

What is an early morning specimen of urine?

Answer 20

The first urine sample of the day

Question 21

When would we carry out urinalysis?

Answer 21

• At each antenatal visit
• On admission to hospital for any reason as a baseline observation
• Specific maternal disorders or treatment e.g hypertensive disease,diabetes
• Clinical symptoms such as raised blood pressure
• Altered micturition

Question 22

What components does urine consist of?

Answer 22

Urine has a pH of 4.5-8 and is mainly made up of water (96%) with 4% dissolved substances such as:

• Urea
• Uric acid,sodium, potassium, sulphates
• Cellular components such as epithelial cells, leukocytes
• Protein and glucose are present in tiny amounts, usually undetectable by routine testing