Urinalysis (Nursing)

00:01 Now, let's take a look at a urinalysis of one of the important test of assessing renal function.

00:07 An in-depth assessment of a urine sample by a train lab or health care professional can tell you a lot of information about your patients.

00:14 We can use it to assess for a UTI a urinary tract infection kidney problems or even diabetes.

00:21 Now the healthcare provider may want to sample a first void.

00:25 That means you're going to ask the patient to do the urine sample at home if they're an outpatient or in the hospital.

00:30 But it needs to be the first void.

00:32 That's when they get up in the morning the first time they pee that's what we're looking for because it's more concentrated.

00:39 So if that's what the healthcare provider wants will usually include that in the order.

00:43 Now a clean catch urine sample might also be required that requires teaching the patient how to clean their urinary tract area, and that will have to start their stream.

00:53 Stop it then put the cup underneath and get a clean catch urine sample.

00:58 We're trying to avoid getting all the skin cells or other floor into the urine sample by cleaning the area very well starting a stream stop it and then getting a sample.

01:08 Now we can diagnose some kidney problems with a urinalysis like chronic glomerulonephritis, nephrotic syndrome, acute glomerulonephritis, rapidly progressing glomerulonephritis, or asymptomatic hematuria or proteinuria.

01:23 So these diagnosis can be hinted that were supported by looking at a urine analysis because the urine Calluses looks at color.

01:32 First of all, yeah, seriously, but actually look at the urine sample and then identify the type of color.

01:39 The look at the appearance the hold it up and see is it clear or is a cloudy.

01:43 Urine without problems should be clear if there's floating kind of hazy milky substance in it.

01:51 Then that's considered cloudy and usually a sign of some type of infection.

01:55 Also will look at the odor.

01:57 This would not be my favorite job to get to smell the urine, because there's some pretty intense smells that can be made.

02:04 So first of all, we're going to do an overall kind of big picture view of the urine, the color, the appearance, and the odor Next we can look at the pH level.

02:15 Remember the kidneys are very involved in acid-base Balance.

02:18 So knowing the pH of the urine will also help us, Now that's not all as they say in most infomercials also tell us about the presence of blood, extra protein glucose, ketones, bilirubin, Um cells, crystals, cast which are these weird kind of protein shapes.

02:34 We'll talk about those later bacteria or other germs.

02:39 Okay.

02:39 So (shoosh) that others category is really really big.

02:44 So I want to go back and review the first three things we talked about color, appearance and odor, right? Now we're getting a little more detail when we talk about pH level and then all the other stuff that could be present in the urine.

03:01 Each one of these other categories gives us an idea of what's going on in the body.

03:07 The blood could be a sign of infection or there might be some trauma to the urinary tract increased protein tells me that the kidneys aren't doing well and we watch that very closely and diabetic patients because diabetic patients are at an increased risk for kidney damage.

03:23 So we watch their protein levels in their urine closely as an indication of their kidney function.

03:29 Glucose, Hey, if their blood sugar's really high we can end up with extra glucose in the urine.

03:35 Ketones are something that we look for in a diabetic patient.

03:40 I'm sure you've heard of diabetic ketoacidosis.

03:44 That's when a diabetic client can't get their energy in the form of glucose out of their bloodstream and into their cells.

03:51 So their body will go after fat as a source of energy and one of the waste products of breaking down the fat is ketones.

03:59 So, We usually see this in a patient who's not able to get the glucose into their bloodstream.

04:05 Now, there's some extreme diets that can also cause ketones in your urine, but we're talking about someone who's eating a typical American diet not someone who's on an extremely low carb keto diet.

04:17 Now bilirubin also indications and cells and crystals and casts and we'll talk more about those later.

04:22 But we just kind of put these together in a category say that's why a urinalysis can tell us so much about a patient.

04:29 I mean, Who knew you could learn that much through pee.

04:33 I know you've often wondered.

04:35 Hmm.

04:36 What is urinary sediment? Yeah, try that one at dinner tonight with your family.

04:41 This will go over big.

04:43 Well, here's what it is.

04:44 They take the urine and they centrifuge it.

04:46 So any of this sediments in the urine are on the bottom of the tube then they kind of pour off that fluid on the top of the tube.

04:54 They shake it up again.

04:56 And then they look at this They look at it under the microscope.

04:59 They look at sediments, cells, crystals, or other substances that might be there.

05:04 So this part of a urinalysis looking at urinary sediment is going to require a microscope to look for all these special types of cells and other substances.