urinalysis and urine culture

Diagnostic Test in Urinary System

By Dina Dewi S L I

Urine Studies (Urine Test)

Tes Urin merupakan prosedur diagnostik pada urin yang bertujuan untuk melihat adanya gangguan pada ginjal atau saluran kemih

Tes ini terdiri dari beberapa :• Urinalysis• Culture & Sensitivity• Urin 24 jam• Electrolite• Protein• Creatinine

The Nurse

• Check physician orders• Keep it Simple directions to client• Standard precautions• Label specimen• Timely• Documentation

Obtaining specimen

• Wash hands• Clean meatus, female front to back• Start stream, then stop, collect specimen• Aseptic technique• Bedpan/mexican hat• To lab 15-20min post collection

Children

• Pediatric bags ( u Bag)• Never squeeze diaper

Specimen Collection

1. Random Specimens Clean-not sterile Ordered for

Urinalysis testing Measurement of specific gravity pH Glucose levels

Urine specimen collection

2. Midstream Specimen Clean voided C&S 30-60 mls urine

3. Sterile Specimen Indwelling catheter Drainage bag

Urine collection

4. Timed urine specimens 2-72 hr intervals (24hr most common) Begin after urinating Note start time on container & requisition Collect all urine in timed period

Post Reminder Signs

Indwelling Catheter

• Strict aseptic technique• Only from Bag if Brand new• Sampling Port?• Clamp 30 min. prior• Wash hands – Glove• Cleanse port with alcohol swab• Sterile needle• To lab 30 min (may refridge 2hrs)

Common Urine Lab Tests• Routine Urinalysis– Examine within 2hrs– 1st voided specimen in AM– Reagent strip

• Specific Gravity– Concentration– 1.010-1.025

• Urine glucose– Diabetics– Reagent strips– Double void

TEST NORMAL VALUESColor Pale yellow to amberTurbidity Clear to slightly hazySpecific Gravity 1.015-1.025pH 4.5-8.0Glucose NegativeKetones NegativeBlood NegativeProtein NegativeBilirubin NegativeUrobilinogen 0.1-1.0Nitrate for Bacteria NegativeLeukocyte Esterase NegativeCasts Occasional hyaline castsRed Blood Cells Negative or rareCrytals Acid Urine:

Amorphous uratesUric acid

Normal Value of Urine StudiesTEST NORMAL

RESULTEXPLANATION NURSING

RESPONSIBILITIESUrinalisis Warna, bau, BJ,

pH, Protein, Glukosa, Keton, RBC, WBC, Bakteri

Biochemicak & mikroskopis

Midstream clean cacth tecnique.Memberikan KIE yang jelas tentang cara pengambilan urin. Menggunkan teknik steril pada klien dengan indwelling kateter

Kultur & sesitivity No bacteria Ditempatkan dalam medium dan di biakkan. Untuk sensitivity bakteri ditumbuhkan dlm media yang mengandung antibiotik

Midstream clean cacth tecnique.Memberikan KIE yang jelas tentang cara pengambilan urin. Menggunkan teknik steril pada klien dengan indwelling kateter

Cont…TEST NORMAL RESULT EXPLANATION NURSING

RESPONSIBILITYUrin 24 Jam

Electrolyte•Sodium•Chloride•Potasium•Calcium

•Magnesium

40-220 mEq/Hr110-259 mEq/Hr25-125mEq/Hr100-300mg/24 Hr7,3-12,2 mg/dL

Ekskresi elektrolit dalam urin tergantung pada intake. Data penunjang pada klien dengan gangguan renal, cairan & elektrolit, asambasa

Mengambil specimen dan menentukan zat tambahan yang diperlukan sesuai dengan tes yang dilakukan. Menyimpan spesimen dalam refrigator.

•Protein

•Creatinine

Rest: 50-80 mg/dLAmb : <150

Identifikasi penyakit ginjal

Dipstick

RENAL FUNCTION TESTS

• Renal function tests are used to evaluate the severity of kidney disease and to assess the patient’s clinical progress. These tests also

provide information on the effectiveness of the kidney in carrying out its excretory function

Laboratory TestTEST Normal ValueBUN 5-20 mg/dL, sedikit meningkat

pada lansiaSerum Creatinine F: 0.5-1.1 md/dL

M : 0.6-1.2 mg/dLCenderung menurun pada lansia

Cr Clearance F : 88-128 mL/minM: 97-137 mL/minCenderung menurun pada lansia

Serum albumin 3.2-5 g/dL 3.2-4.8 g/dL pada lansia

Referensi

• Burke, Lemone, Mohn Brown. 2006. Medical Surgical Nursing Care. 2nd Ed. Australia: Pearson Education