urinalysis and urine culture
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Urinalysis and Urine CultureTRANSCRIPT
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Diagnostic Test in Urinary System
By Dina Dewi S L I
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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
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The Nurse
• Check physician orders• Keep it Simple directions to client• Standard precautions• Label specimen• Timely• Documentation
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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
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Children
• Pediatric bags ( u Bag)• Never squeeze diaper
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Specimen Collection
1. Random Specimens Clean-not sterile Ordered for
Urinalysis testing Measurement of specific gravity pH Glucose levels
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Urine specimen collection
2. Midstream Specimen Clean voided C&S 30-60 mls urine
3. Sterile Specimen Indwelling catheter Drainage bag
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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
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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)
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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
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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
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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
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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
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Dipstick
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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
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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
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Referensi
• Burke, Lemone, Mohn Brown. 2006. Medical Surgical Nursing Care. 2nd Ed. Australia: Pearson Education