Urinalysis

Why is it done?

· Detection of urinary tract infections

· Diagnosis of pregnancy

· Screening e.g. sexual health

· Monitoring and management of a condition e.g. renal failure

Equipment:

· Gloves and apron

· Urine dipstick

· MSU collection pot

· Paper towels

· Pen

· Watch

Introduction/ explanation:

· Wash hands and introduce yourself

· Confirm patient details; name, age, DOB and hospital ID

· Explain the collection procedure - mid stream sample of urine (MSSU) is the most common

MSSU = Want them to pass water first, then without interrupting the flow, collect about 10mL of water into the container

· Explain you will then be testing the urine to test it’s contents

· Ask if they understand what they need to do and ask if you have their consent to continue

Preparation:

· Set up equipment Place 2 paper towels on the table – 1 vertically and 1 horizontally Place watch next to paper towels

· Write out substances which are being tested on the vertically place paper towel This will allow you to fill the results in once the dipstick has been dipped

· Check dipsticks are in date

Procedure - Inspection

· Wash hands, don gloves and apron

· Check the sample – colour Straw coloured (normal) Red (haematuria) Dark (dehydration)

· Check the sample – transparency Clear/ frothy/ cloudy

· Remove the cap and assess the smell Urinoid (normal) / sweet (diabetes) / strong (dehydration) / offensive (infection)

Procedure - Dipstick testing

· Check the dipstick are in date

· Remove a strip and place on a clean blue roll Replace top immediately – when exposed to the atmosphere, they render the strip zone inaccurate

· Remove the cap from the urine bottle and dip the test strip in Ensure all the test zones are submerged in the urine sample

· Wipe residual urine on the paper towel and leave it face up so the reagent strips are visible

· Remove one glove and hold the dipstick pot in the other

· Compare the different reagent pads to the dipstick pot Remember different tests need to be read at different times!

· Use the un gloved hand to write down the results

Documentation:

· Clear equipment

· Remove gloves and apron

· Wash hands

· In black pen document Patient’s details: Name, DOB, date examination, signature and name printed, job title Urinalysis of a mid-stream sample of urine Document the colour / odour/ turbidity/ results

Questions:

1) Give 3 reasons for performing urinalysis.

2) What might: a) Sweet smelling urine indicate? b) Strong, offensive smelling urine indicate? c) Plain smelling urine indicate?

3) Look up the different reagents to be tested.

What would a high …. Indicate? a) Glucose b) Protein c) Ketones

4) What is the most common cause of a urinary tract infection?

5) How would a UTI present?

6) Name 3 causes of haematuria? What would be the most concerning cause?