00:00
So we can learn a lot from
urine specific gravity.
00:03
We're just starting to peek into
what we can do.
00:06
But just like any other test,
if there's an abnormal value,
you need to explore it more.
00:13
When we say abnormal,
if it's too low or too high,
this is probably indicating
an imbalance
in the patient's fluid status.
00:21
Now, a specific gravity
won't tell me the cause,
that's my job to figure it out.
00:27
But a urine specific gravity test
will tell me there's an imbalance.
00:31
So, I'm going to need to dig into
the possible causes
for the abnormal value
and figure out
what assessments I need to do,
what questions I need to ask.
00:39
Because that's what nurses do.
00:42
That is the fun part of getting a
lab value back and applying it,
figuring out what's going on
in your patient
so you can keep them safe.
00:51
So this urine specific gravity
measures the concentration.
00:56
When we're talking about
concentration,
we're comparing the patient's urine
to a standard of pure water.
01:02
So this number will give us an
indicator of the kidneys function
and a person's
bodily fluid status.
01:09
Okay.
01:10
So first out of the chute,
what do we know?
Urine specific gravity would tell me
something about kidney function
and something about
your patient's body fluid status.
01:21
We know the normal values
1.010 to 1.030.
01:28
Now, I want you to do,
can you remember what a
neonate value is?
See if you can remember
what a normal
baby baby kidneys value is.
01:36
Right.
01:37
1.003.
01:39
Good deal, you're really
tracking with us.
01:42
I want to talk to you about
abnormal values.
01:45
I know you see a lot of numbers,
and I use a lot of repetition,
but that's by design,
because I want you to hear
the most important concepts
over and over again.
01:55
So that when you're practicing
as a nurse,
it pops right to the top
of your head.
01:59
So let's look at the
abnormal values.
02:01
We're talking about
urine specific gravity.
02:04
Whenever you're looking at
lab tests, you think,
"Okay, what is this test?
Tell me about a patient?"
Urine specific gravity tells you
a lot about a fluid volume status.
02:15
Now, you might hear
your faculty say that
or throw that word around,
and you're thinking,
"What do they mean?"
Well, we're talking about
the amount of volume
in your intravascular space,
your veins and your arteries.
02:26
Okay, so...
02:27
if it's appropriate,
my heart can pump
blood goes around
at the right speed,
we're not damaging organs,
the kidneys aren't getting
too much blood,
or they're not getting
enough blood.
02:36
It's appropriate.
02:38
It's just right,
like Goldilocks would say.
02:42
So urine specific gravity
can kind of give me
some information,
a peek,
into a patient's
fluid volume status.
02:49
Now, if they're getting
too much fluid,
I want to watch out for that
because I could throw them into
heart failure.
02:55
If they're getting not
enough fluid,
if that balances out
in that intravascular space.
03:00
Then they're not going to perfuse
my organs.
03:04
So when I don't have
enough volume on board,
if it's severe enough,
or for a long enough
period of time,
my kidneys start taking a hit.
03:12
They're not perfused
and could be damaged.
03:14
So when you look at
urine specific gravity,
this is so much bigger
than numbers.
03:19
You're looking at how is that
patient's overall body working?
This lets me know if their current
fluid intake is way too much,
and I'm at risk and throwing them
into failure or not enough,
and we might throw them into
hypovolemic shock.
03:35
It's right.
03:37
Urine specific gravity
can help us peek into that,
because it's the possible causes
of the abnormal values
that you need to look at,
right?
So when you get a number,
that's not within a normal range,
it's not just a number,
it's a warning sign to you
to know where to look
for the bigger problem.
03:54
So these are the things
I want you to think through.
03:56
Think about a heart condition.
03:58
Remember, we're worried about
someone's in heart failure.
04:00
Think of the kidney problem,
or a metabolic disorder
like diabetes insipidus
or SIADH.
04:07
We'll talk more about those later,
but they're super cool.
04:11
Let me just remind you,
that this is the beginning steps
in understanding
what's going on
in the rest of your patient.
04:19
If you have an abnormal value,
that's an early warning sign to you
to ask more questions.
04:25
Look at their
cardiovascular system,
look at their renal system,
look at their metabolic
or endocrine system.
04:30
It's going to give us clues
to what is going wrong there.