Glucose – Substance in Urine (Nursing)

00:00 Okay.

00:01 Now let's look at the next part of your results.

00:04 So look at this.

00:04 Some of these may be present.

00:06 So there might be some glucose, some your virgin, some blood, some protein.

00:11 You've got the whole list there and we've got a cheat sheet for you at the end that puts this all together.

00:17 But some of these may be present in your urine, and it's okay.

00:22 We're not worried about it.

00:23 Let's look at glucose in your urine.

00:25 Normal levels of glucose would be less than or equal to 130.

00:30 So glucose is normally filtered by the glomerulus.

00:33 What is the glomerulus? Yeah, it's that tangle of capillaries that's right inside of Bowman's capsule and it's all connected up to the tubules and your kidneys.

00:43 So glucose is normally filtered by the glomerulus, but almost completely reabsorbed in the proximal tubule.

00:51 So when we say that, that's great to have the definition, but I want you to picture it.

00:55 So you have that picture in your mind of what a Marius looks like.

00:58 It's a tangle of capillaries.

01:00 Inside of Bowman's capsule. Right.

01:03 And that is connected to the tubules.

01:06 So when it says that glucose is almost completely reabsorb in the tubule, that means it comes out of the filtrate, back into the body circulation.

01:15 It should not be leaving the body in the urine.

01:19 So it's okay to have less than or equal to 130.

01:23 But if you've got more of that, we've got a problem.

01:27 Now glycol Surya means you've got glucose, usually around 180 to 200.

01:33 Normal is less than 130.

01:35 Once you hit 180, you get a diagnosis.

01:38 So there's that word again, urea.

01:40 That means urine.

01:42 Whatever comes in front of that means what's in the urine.

01:45 Oh, glucose.

01:46 So that's why glucose.

01:47 Urea means a too high of a level of glucose in your urine.

01:52 That means the filtered load of glucose exceeds your kidneys ability to reabsorb it. Huh.

01:59 I wonder who would have too much glucose in their blood to the point where the kidneys couldn't reabsorb it? Yeah, you're right.

02:09 Let's look at the possible causes.

02:10 Ding, ding, ding, ding, ding.

02:11 Number one, diabetes mellitus.

02:14 Or if you prefer mellitus, however you want to say it, that's who's going to have too much blood sugar.

02:22 Right.

02:22 People with diabetes.

02:24 That is the that's the risk.

02:26 And the cause of diabetes is an elevated blood glucose level.

02:30 So when that blood is heading on into the kidney, it is over saturated with glucose.

02:36 It is more than the kidneys can or should reabsorb, which is why it tries to get rid of some of it in the urine.

02:45 So if someone has glucose here, we would expect they have diabetes.

02:49 Now, Cushing's syndrome, we're back to that endocrine system.

02:53 If a patient has Cushing's syndrome, this happens with someone who's received high dose corticosteroids.

02:59 So not somebody who usually has an inhaler.

03:02 Talking about somebody who's been on pretty high dose glucocorticoid therapy, either taking it by a pill or I.V., they tend to have more systemic results.

03:14 But remember, they end up with those weird side effects like moon face, facial hair, mood swings, all kinds of weird stuff.

03:20 But Cushing's syndrome looks like Cushing's disease because they have excess glucocorticoid.

03:29 So remember, glucocorticoids come from my adrenal glands, right? They come from the adrenal cortex.

03:36 But when I give them to you as a medication, then I can cause Cushing's syndrome.

03:41 It's like your adrenal gland said, Hey, party.

03:44 And it just starts shooting out way too much.

03:47 Well, in Cushing syndrome, we did that to you.

03:51 You're welcome. No charge.

03:53 Cushing syndrome happens when a patient receives excess high doses of glucocorticoids because we're trying to suppress inflammation somewhere in their body that messes with their protein, fat and sugar metabolism.

04:06 So that's why you end up with excess levels of glucose in your urine.

04:12 If someone's on glucocorticoid therapy, their blood sugar is usually elevated.

04:17 If you've got a diabetic on glucocorticoid therapy, their blood sugars can go crazy.

04:23 Now, we also have issues with liver and pancreatic diseases and something we call Fanconi Syndrome.

04:30 Now you can follow that away is fun trivia.

04:33 The most important point I want you to take away are diabetes, Cushing's and then your liver and pancreatic diseases.

04:42 Then Cooney's we put on there, but we're not even going to delve into it.

04:45 It's just something interesting for you to know.

04:48 But number one, take away diabetes.

04:50 Second one, Cushing's syndrome.

04:53 And make sure you got to know that that's caused by glucocorticoid medications.

04:58 And then liver and pancreatic disease, because those are key players with endocrine and hormone.