URINALYSIS

URINALYSIS

INTRODUCTION

Urinalysis performed at every visit to exclude abnormality (way 2000). The woman can be shown how to test her own urine and encouraged to test it at subsequent visits. At the first visit a midstream specimen may be sent to the laboratory for culture to exclude a culture is grown of specific may be sent to the laboratory for culture to exclude a culture is grown of a specific may be sent to the laboratory for culture to exclude a culture is grown of specific may be sent to the laboratory for culture to exclude asymptomatic bacteruria. This condition exists when a culture is grown of a specific bacterium that exceeds 10⁶ organisms per milliliter of urine. As it is a asymptomatic the woman is unaware of disease. Pyelonephritis can readily develop from it because of the changes in the renal tract during pregnancy.

Other possible findings during subsequent routine urinalysis include:

·       Ketones due to fat break down to provide glucose, caused by unmet fetal demands that may be due to vomiting, hyperemesis, starvation or excessive exercise.

·       Glucose caused by higher circulating blood levels, reduced renal threshold or disease.

·       Protein due to contamination by vaginal leucorrhoea, or disease such as urinary tract infection or hypertensive disorders of pregnancy.

PROCEDURE

Preparation of the articles:

A tray containing:

1.     Test Tubes -2 on a test tube stand

2.     Test tube holder – 1

3.     Spirit lamp – 1

4.     Match box – 1

5.     Rag pieces

6.     1% acetic acid

7.     Benedict solution

8.     Red& blue litmus paper

9.     Urinometer

10.  Kidney tray

11.  Dropper – 2

12.  5-10ml measuring cup

13.  Urine in a bottle

Reaction test:

Normal urine usually dip one end of a litmus paper into the urine if the urine is acidic blue litmus paper turns into red. If the urine is alkaline the red litmus paper is changed into blue. Normal urine is acidic in reaction.

MEASURING SPECIFIC GRAVITY OF URINE:

DEFINITION: Specific gravity – the concentration of dissolved substances in water, can be measured easily by the nurse in any clinical setting.

Urinometer with a mercury bulb in a cylinder containing urine is used. The density or concentration of urine determines the level at which the urinometer floats within the cylinder. If the urine is dilute, the urinometer tends to sink. Concentrated solutes in urine raise the level at which the urinometer floats.

Urinometer – due to Archimedes principle – a body immersed in a fluid is buoyed up by a force equal to the weight of the fluid it displaces.

Specific gravity of urine is the relation of the weight of a known quantity of urine to the weight of an equal quantity of water.

Specific gravity of the urine – 1.003 – 1.030

SL.NO.	STEPS	RATIONALE
1.	Wash hands	Reduces transmission of micro organisms.
2.	Pour fresh urine specimen into glass cylinder until it is two-thirds to three quarters full.	Cylinder must be at least two-thirds full to cause urinometer to float.
3.	Place urinometer in cylinder of urine and gently twirl top of stem.	Prevents urinometer from adhering to sides of the cylinder.
4.	Wait until urinometer stops bobbing. Then with urinometer at eye level read point where urine level read point where urine level touches calibrated scale at lowest point of meniscus for best accuracy.	Concentration of dissolved solutes in urine influences depth at which the urinometer floats. Point at which urine reaches scale is specific gravity.
5.	Discard urine and wash cylinder & urinometer in cool water.	Warm water coagulates protein in urine and causes them to stick to glass surfaces.

Albumin Test:

NURSING ACTION	RATIONALE
1.     Wash hands	It reduces spread of micro organisms.
2.     Fill ¾ of a test tune with urine. Heat upper third of urine with the spirit lamp and allow it to boil.
3.     Keep the mouth of the test tube away from your face.	To prevent scalding.
4.     The cloud may appear	Due to phosphate or albumin.
5.     Add acetic acid 1-2 drops by dropper into the test tube. If the urine still remains cloudy it indicates the presence of albumin if it becomes clear it indicates the presence of phosphates.	Due to phosphate or albumin.
6.     Clean and replace the tube.
7.     Record the findings in the vital signs chart urine albumin column.	Documentation helps to evaluate client’s condition.

Cold Test:

1.     Take 3% of nitric acid or sulphosalicylic acid in clean test tube.

2.     Allow equal quantity of urine to trickle down the sides of the test tube.

3.     If albumin is present a while precipitate will be seen where two fluids meet.

TEST FOR SUGAR:

NURSING ACTION	RATIONALE
1.     Wash hands.	It reduces spread of micro organisms.
2.     Use the double voided specimen to do a urine test for sugar.	The first void specimen of the morning urine was in the bladder over night and may contain excessive glucose due to food ingested in the previous evening and increase the concentration of urine.
3.     Take 5ml of benedicts solution in a clean test tube.	The formula of Benedict’s solution is sodium carbonate – 100gms, sodium citrate – 173 gms, Copper sulphate – dissolved in 100ml of distilled water, chemical action takes between sugar in the urine and copper sulphate.
4.     Boil the solution in the test tube and hold the test tube away from your face.	It prevents scalding.
5.     If there is no colour changes in the benedicts solution add 8 drops of urine with the help of the dropper in to the test tube.	To check the urine for sugar.
6.     Boil it again for 2 minutes and read the result.	Colour indicates the amount of sugar in the urine.
7.     If colour remains Blue – no sugar Green – 1% sugar Yellow – 2% Orange – 3% Brick red – 5% and above.
8.     Wash and replace the articles.	For reuse.
9.     Record the findings in the urine sugar chart.	Documentation helps to evaluate the client’s condition.

CONCLUSION:

Thus urinalysis is performed at every visit to exclude abnormality. So the woman should be taught how to test her own urine and encouraged to test it at subsequent visits.