Interpreting Urine Dipstick Tests (Nursing)

by Prof. Lawes

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    00:00 Alright, if you're in a super hurry, this sheet is going to tell you the basics of what you need to know from this particular type of dipstick. So let's look at leukocytes. If this is positive, what does that tell me? Well, that may indicate an infection in the kidneys and the urinary tract. Nitrites, uh, another sign of UTI because bacteria convert nitrate to nitrite and that's an indication of an infection. Urobilinogen, uh, we're going to look at your liver. That may indicate some liver cell damage or you got a whole lot of bilirubin excretion going on in the gut. Now protein could indicate kidney disease. There're a lot of reasons we'd get to kidney disease but protein in the urine is a sign that that kidney is struggling. pH is the urine acidity level. Now acidic urine might be caused by kidney disease but it also might be caused by something that your patient ate. Remember assessment, asking the right questions. You're the key to keeping your patient safe. Blood in the urine may indicate infection or disease in the kidney and bladder. Now, if you're female and the female is cycling, she is having her period, menstruation, you just note that on the sticker. We can still do this but we'll know that that blood is likely a cause for menstruation. Specific gravity can give us information on the kidney's ability to concentrate urine in relation to their plasma. Ketones could be associated with diabetes or someone who might be on a low-carb extreme diet or starvation.

    01:33 Bilirubin, again we're back to liver damage and glucose could indicate diabetes. Okay, I just gave you a whole bunch of information. What I want you to do now is kind of look at things together. If I was a diabetic client and I think the disease would kind of progress, what am I likely to see? Let's group them that way. While we know that diabetics have kidney damage, so protein, probably I'm definitely going to see protein. Now, if the specific gravity is high that could tell me that the patient also has high glucose, so let's go down and look at the glucose.

    02:10 I would expect that is high if the blood sugar has not been controlled. So, as you practice, you'll start to look. You will look at all of these, but I want you to be thinking through and applying, and what a diabetic has kidney damage, and their glucose has not been well managed, then I'm going to expect to see some protein in their urine because that means the kidneys were struggling. I'm going to see glucose in their urine if it's not well controlled, and I would expect a higher specific gravity because there's extra glucose in their urine. When their blood sugar is high, the kidney cannot reabsorb all that glucose back into the bloodstream and it shouldn't, so it ends up going out into the urine. So, you really can learn a lot about a patient just from a dipstick test. I wanted to make sure to point this out before I wrap up this video series that not all dipsticks are the same. We walked through 1 example of a dipstick but there are multiple varieties out there. Dipsticks can have a range of parameters. Now, that's the official way of saying they can test your urine for lots of different substances. So, it's very important that you read the product description carefully. You want to make sure that what you're testing for is on that strip and that you know what each box represents.

    03:27 So, let's give some examples of things that we didn't discuss in this video. So urine dipsticks can be used for things like drug screening. Now that's most often at a place of employment to make sure the employee is negative for a certain drug but we didn't go over that on our dipstick because it wasn't included in the parameters we looked at. Microalbumin is another example. That's another option you may see on a dipstick but I just want to tell you keep in mind that the urine albumin-creatinine ratio is more sensitive and a more accurate test than any dipstick. So, always remember not all dipsticks are the same.

    About the Lecture

    The lecture Interpreting Urine Dipstick Tests (Nursing) by Prof. Lawes is from the course Interpretation of Renal Lab Values (Nursing).

    Included Quiz Questions

    1. Leukocytes
    2. Nitrites
    3. Ketones
    4. Protein
    5. Glucose
    1. Elevated glucose
    2. Elevated Ketones
    3. Elevated urobilinogen
    4. Lowered specific gravity
    5. Lowered proteins

    Author of lecture Interpreting Urine Dipstick Tests (Nursing)

     Prof. Lawes

    Prof. Lawes

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