Introduction to Urine Protein Test (Nursing)

by Rhonda Lawes, PhD, RN

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    00:01 Welcome to our video series on interpreting lab values.

    00:04 In this section, we're going to talk about an important test.

    00:08 It's the urine test for protein.

    00:10 Now you think about a urine test, what do we need? Obviously we need urine, but you need at least 30 milliliters of urine.

    00:18 So that's not really that much unless you need it.

    00:21 Sometimes it's hard for patients to produce it.

    00:24 But 30 mls is the equivalent of one ounce.

    00:27 You can put that in a clean specimen cup, it doesn't have to be be sterile.

    00:31 We're not culturing anything and it we're just looking for urine.

    00:34 So we need 30 mls of urine in a clean specimen cup.

    00:39 Now this word is a very difficult for me to say, albuminuria, right? That is one that my tongue just gets twisted around, but let me break it down for you because when you understand these word parts, it helps you recognize terms or other terminology that you might not have known the definition for.

    00:57 So albuminuria, look at that.

    00:59 I want you to underline uria.

    01:02 And the second word proteinuria underline uria, that means urine.

    01:08 So what that's telling me is whatever is before the letters URIA, that's what's in my urine.

    01:16 And now you might have a little bit of protein in the urine but abnormal levels indicate a problem.

    01:21 See protein is supposed to stay in your bloodstream.

    01:25 Remember, it's that big molecules charged in a way that attracts water that helps us keep water in our intravascular space.

    01:32 When the blood goes through the kidney, we want the protein to stay in the bloodstream not to exit out into the urine.

    01:40 So you should find protein in your bloodstream, but it should not be present in your urine.

    01:46 Stop for a minute and look at that value greater than 30.

    01:50 That's a number I want you to remember.

    01:53 You can have some protein in your urine, but if it's bigger than that number 30, we've likely got a problem with your kidney.

    02:00 So why is albuminuria a problem? Well, I bet you can answer that question now on your own.

    02:07 If you want to feel unlucky today pause and see if you can answer that question by yourself.

    02:15 Okay, so let's look at break it down.

    02:17 Why albuminuria is a problem.

    02:20 On the left, you have a healthy kidney, on the right, you have a damaged kidney.

    02:25 Okay work with me I know it's just a circle but it's the same thing.

    02:29 Look at the kidney is supposed to filter the blood and dump what we don't want into the urine.

    02:35 So you see both have two circles.

    02:37 Those are going to represent your kidney.

    02:39 Top half of the circle is blood.

    02:41 Bottom half of the circle is urine.

    02:43 Yeah, I you probably could have figured that out because one is red and one is yellow just like body fluids are supposed to be but work with me here.

    02:51 Let's walk through it.

    02:53 So you'll notice on the healthy kidney, when you have the protein in the blood, that's where it stays.

    02:59 Look there's none of it in the urine, but look at the damage kidney.

    03:04 It isn't able to keep the protein in the bloodstream and it's ending up depositing it in the urine.

    03:11 The damage kidney has albumin in inappropriate places in the urine so this is likely an early sign of kidney disease.

    03:19 Now if you have three positive results over a period of three months or more it is a sign, a definitive sign of some form of kidney disease.

    03:29 All right. So as a nurse, why do I need to know this? Well, you need to know 1.

    03:33 Protein is supposed to stay in your bloodstream helps me with fluid pressure keeping everything in my intravascular space.

    03:41 2.

    03:41 If I have to high levels of protein, I don't get super alarmed with the first one.

    03:47 But if I have a series of three tests over at least three months or even a little bit longer period of time this is a sign of kidney disease and this patient needs very close and consistent follow up.

    03:59 Now what kind of people do you think should be tested, right? We're looking for people who are at an increased risk for kidney disease.

    04:05 So this should be a part of their routine checkup by a healthcare provider every time they go and see their primary health care provider.

    04:13 They should have this test done.

    04:15 They should have a urine sample and you should look for protein.

    04:18 So first up.

    04:19 Yeah, most important people with diabetes.

    04:23 Okay, so anyone with type one, type two, any type of diabetic client should have their urine tested every time that's a minimum standard because we know that a really high risk for kidney damage.

    04:38 Next number two in the risk category would be people with high blood pressure.

    04:43 Remember the glomeruli everything is very fragile.

    04:46 And if you were just hammering that kidney with a really high blood pressure.

    04:52 You're damaging that fragile inner workings.

    04:55 So people with high blood pressure, even if they don't have diabetes or risk for kidney damage.

    05:01 Now if you are diabetic and you have high blood pressure, you're increasing your risk for kidney damage.

    05:08 Now if your family has a history of kidney failure, then you should be tested this runs in my family.

    05:14 My dad ended up with chronic kidney disease and renal failure.

    05:17 So this is something that my family physician follows every time I go in for a checkup, and if you're 65 years of older as you age, the organs, they just start wearing out, their tired.

    05:28 So that's why people who age was you keep an eye on that because we know kidneys are at a high risk.

    05:34 Now the last one might seem kind of strange to you, but there's certain ethnic groups African-Americans, Hispanics, Asians and American Indians or Native Americans whatever your reference of choice is we know that these certain ethnic groups have a tendency to have a higher risk for renal disease.

    05:54 Okay, so we got five things at there, I want you to stop for just a minute and see how am I going to keep this in mind? How is this going to make sense to me? Well diabetes and high blood pressure probably were at the top of your list already, but the rest of it has to do with me and my family so think about family history, certain races and then sadly as you age it just comes on.

    About the Lecture

    The lecture Introduction to Urine Protein Test (Nursing) by Rhonda Lawes, PhD, RN is from the course Urine Protein – Urinalysis (Nursing).

    Included Quiz Questions

    1. 30 mg/g
    2. 20 mg/g
    3. 35 mg/g
    4. 25 mg/g
    1. Sustained proteinuria is a sign of kidney disease
    2. Protein maintains intravascular fluid pressure
    3. Proteinuria is diagnosed by two positive results over a two month time period
    4. Proteinuria occurs because of a diet high in protein
    1. Clients diagnosed with hypertension
    2. Clients diagnosed with diabetes
    3. Clients that are Hispanic
    4. Clients that have a medical history of stroke
    5. Clients diagnosed with a bladder infection

    Author of lecture Introduction to Urine Protein Test (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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