Urine Testing Uses – Purpose, Characteristics, Examination, Preliminary Assessment, Equipment, Procedure, Urine pH, Gravity, After Care

Urine Testing Uses – Purpose, Characteristics, Examination, Preliminary Assessment, Equipment, Procedure, Urine pH, Gravity, After Care

UPDATED 2024

Urine testing, also known as urinalysis, is a diagnostic test that involves analyzing a person’s urine for various markers, compounds, and characteristics. This type of testing can provide valuable information about a person’s overall health, help diagnose medical conditions, and monitor the effectiveness of treatments.

USES OF URINE TESTING

Here are some common uses of urine testing:

Drug Testing: Urine tests are frequently used to screen for the presence of drugs and their metabolites. This is common in workplaces, athletic organizations, and legal situations.
Medical Conditions: Urinalysis can help diagnose various medical conditions, such as diabetes, kidney diseases, urinary tract infections (UTIs), and liver problems. Abnormal levels of glucose, protein, blood cells, or other substances in the urine may indicate an underlying health issue.
Pregnancy Testing: Urine tests are often used to detect the presence of human chorionic gonadotropin (hCG), a hormone produced during pregnancy. Home pregnancy tests typically use urine samples for this purpose.
Kidney Function: Urine tests can provide information about kidney function by measuring levels of creatinine, urea, and other substances. Changes in these levels can indicate kidney problems.
Metabolic Disorders: Certain metabolic disorders, such as phenylketonuria (PKU) or maple syrup urine disease (MSUD), can be diagnosed through urine testing.
Monitoring Medications: Some medications can be monitored through urine testing to ensure that they are at therapeutic levels and not causing adverse effects.

URINE TESTING

Urine
analysis methods comprise testing reaction, specific gravity, albumen, sugar,
bile, acetone, pus, blood and yeasts microscopically

Purpose

To detect reaction, in cystitis the
reaction is alkaline
To detect sugar, it is present in
diabetes mellitus
To detect – protein it is present in
kidney damage, pre-eclampsia and is called proteinuria
To detect acetone, it is present due
to incomplete metabolism of fat
To detect bile – it is seen in cases
of obstructive jaundice or hemolytic diseases
To detect pus cells – it is present
due to urinary tract infection
To detect blood – it is seen in snake
bite, fracture pelvis, etc

Characteristics of Normal Urine

Volume: 1,000 to 2,000 ml in 24 hours
Appearance: clear
Odor: aromatic color
Color: amber or pale straw in color
Reaction: normal urine is slightly
acidic
Specific gravity: 1.010 to 1.025
Constituents of the normal urine:
water 96 percent, urea 2% and uric acid, urates, creatinine, chlorides,
phosphates, sulfates, oxalates – 2%

Characteristics of Abnormal Urine

Volume

Polyuria – increased in volume
Oliguria – decreased in volume
Anuria – total absence or marked
decrease of urine
Suppression – failure of the kidney
to secrete urine

Color

Green or brownish yellow – bile salts
and bile pigments
Reddish brown – urobilinogen
Bright red – a large amount of fresh
blood
Smokey brown – blood pigment
Milk white – chyluria due to filariasis

Appearance

Mucus – appears as a flocculent cloud
Pus – settles at the bottom as a
heavy cloud
Stones – as fine sand
Uric acid – as grains of pepper

Odor

Sweetish or fruity odor – seen in
diabetes

Reaction

Alkaline – cystitis
Specific gravity
Diabetes mellitus – increased
specific gravity
Renal disease – low specific gravity
Constituents of urine
Kidney damage – albumin

Types of Examination of the Urine

Physical examination: color
appearance, volume, reaction, specific gravity and color
Chemical examination: routine tests
such as for albumin and sugar. Special tests such as tests for acetone, bile
pigments and bile salts. Microscopic examination – crystals, casts, RBC, pus
cells, epithelial and bacteria

Preliminary Assessment

The doctor order for any instructions
Articles available in the unit
General condition and diagnosis of
the patient
Self-care ability of the patient

Preparation of the Patient and Environment

Explain the procedure to the patient
Keep the urine sample ready
Arrange the articles ready in the
treatment
Provide labeled container for
collecting urine

Equipment

Test tubes 4 to 6 on a test tube
Test tube holder – 1
Spirit lamp – 1
Match box – 1
Kidney tray with lining to discard
the wastes
Duster or rag piece – to wipe the
outside of the test tube before heating
Acetic acid – to test urine for
albumin
Nitric acid or sulfosalicyclic acid –
to test urine for albumin
Red and blue litmus paper – to test
the reaction of the urine
Urinometer – to measure the specific
gravity of the urine
Benedict’s solution – to test urine
for sugar
Ammonium sulfate crystals, sodium
nitroprusside crystals and liquor ammonia to test urine for acetone
Weak solution of Tr. Iodine to test
for bile pigments
Sulfur powder: to test for bile salts
Glass jar: to measure the amount of
the urine
Pipette – 2 – to measure drops of
urine and reagents
A small bottle brush – to clean the
test tubes

Procedure

Sugar Test

Take test tube and fix in holder
Pour 5 ml of Benedict’s solution into
test tube
Light spirit lamp and heat Benedict
solution till it boils
Holding test tube mouth facing away
from nurse
Add 8 drops of urine using dropper
and allow boiling for few seconds
Put off flame and cool test tube
under running water

Observations

Blue: Nil
Green: +
Yellow: ++
Orange: +++
Brick red: ++++

Albumin Test

A hot test

Fill 2/3 of test tube with urine,
secure test tube holder at very top
Heat the upper third of test tube
over flame
If there is precipitation, it denotes
the presence of wither protein or phosphate
Add 2-4 drops of 2 percent acetic
acid
If precipitate dissolves it is due to
phosphates present in normal urine
If precipitate does not dissolve it
denotes presence of albumin

Observation

Trace: +
Cloudy:++ (100mg/dL)
Thick cloudiness: +++ (500 g/dL)

Cold Test

Pour a small quantity of nitric acid
or sulfosalicylic acid 3 percent in to a clean test tube
Allow equal quantity of urine to
trickle down the sides of the test tube
If albumin present, a white
precipitate will be seen where two fluids meet

Urine pH

Collect and keep ready with urine
sample
Dip litmus strip in urine and keep
for one minute
Note color change
Discard strip into container for
infected waste

Urine Specific Gravity

Fill 3/4 of jar with urine
Gently place urinometer into jar
When urinometer stops bobbing
Read specific gravity directly from
scale marked on calibrated stem of urinometer
Make sure that instrument floats
freely and does not touch sides of jar
Read scale at lowest point of
meniscus to ensure an accurate reading at eye level

Rothera’s Test (Acetone)

Take 2 cm depth of ammonium sulfate
crystals in a small test tube
Add equal volume of urine and one
crystal of sodium nitroprusside
Close the test tube with a cork and
shake the test tube
Take liquor ammonia and add it to the
urine, trickling through the sides
Read the results immediately

Observations

If acetone
is present permanganate purple colored ring is formed at the junction of urine
and ammonia

Hays Test (Bile Salts)

Take a test tube, half full of urine
Sprinkle sulfur powder on the surface
of the urine
If the powder sinks down to the test
tube, it indicates the presence of bile salts

Smith’s Test (Bile Pigments)

Fill 3/4 of test tube with urine
Add iodine drops along the sides of
the tube, so as to form a layer on the surface of the urine
A green color at the junction of the
two liquids indicates the presence of bile pigments

After Care