Urinalysis Lab Worksheet

[Elenor Waas]

TheCLINITEK Status+ Analyzer is an automated point-of-care urinalysis analyzer that aids in the assessment, diagnosis, and monitoring of chronic conditions. It is the only dual-purpose point-of-care analyzer for urinalysis testing and urine hCG pregnancy testing.

The Multistix 10 SG reagent strip is the reliable frontline test for detection of a broad range of conditions, from detecting urinary tract infections (UTI1) to diabetes and kidney disorders. Accurately gain a broader clinical insight into a patient's health.

The Reliable Choice for Urinary Tract Infection (UTI) Detection at the Frontline

A multicenter study was conducted to identify patients with potential UTIs. There were 1,887 urine specimens tested comparing the leukocyte and nitrite results of Multistix 10 SG urinalysis strips to urine culture.1

Over 10 million Americans have difficulty discerning color.3

Studies have shown that when urinalysis is performed with an instrument, sensitivity is increased and positives are correctly identified and reported.4

Instrument-read results provide consistency and reliability, sample to sample: In a study of 10,084 samples, the % error (+/- 1 color block difference) among positive samples was reduced from 12.4% when read visually to 2.9% when read on a CLINITEK analyzer.4

You can download a summary or cheat sheet of this normal laboratory values guide below. Simply click on the images above to get the full resolution format that you can use for printing or sharing. Feel free to share these cheat sheets for normal lab values!

During the last part of diagnostic testing, the nursing care revolves around observations and follow-up activities for the patient. For example, if a contrast media was injected during a CT scan, the nurse should encourage the patient to increase fluid intake to promote excretion of the dye. Additional responsibilities during post-test include:

Here are the normal lab values related to erythrocyte studies which include hemoglobin, hematocrit, red blood cell count, serum iron, and erythrocyte sedimentation rate. Venous blood is used as a specimen for complete blood count (CBC) which is a basic screening test that is frequently ordered to give an idea about the health of a patient.

A blood culture is a fairly routine test that identifies a disease-causing organism in the blood, especially in patients who have temperatures that is higher than normal, for an unknown reason. The test is relatively simple for the patient and involves a simple blood draw.

The test requires little preparation for the patient. The patient will be asked what kind of medications he is taking, including prescriptions and nutritional supplements. The patient may be asked to stop taking certain medications that may alter the blood culture results.

Red blood cells or erythrocytes transport oxygen from the lungs to the bodily tissues. RBCs are produced in the red bone marrow, can survive in the peripheral blood for 120 days, and are removed from the blood through the bone marrow, liver, and spleen.

Hemoglobin is the protein component of red blood cells that serves as a vehicle for oxygen and carbon dioxide transport. It is composed of a pigment (heme) which carries iron, and a protein (globin). The hemoglobin test is a measure of the total amount of hemoglobin in the blood.

Prothrombin is a vitamin K-dependent glycoprotein produced by the liver that is essential for fibrin clot formation. Each laboratory establishes a normal or control value based on the method used to perform the PT test. The PT measures the amount of time it takes in seconds for clot formation, the international normalized ratio (INR) is calculated from a PT result to monitor the effectiveness of warfarin.

The INR standardizes the PT ratio and is calculated in the laboratory setting by raising the observed PT ratio to the power of the international sensitivity index specific to the thromboplastin reagent used.

Activated partial thromboplastin time (APTT) evaluates the function of the contact activation pathway and coagulation sequence by measuring the amount of time it requires for recalcified citrated plasma to clot after partial thromboplastin is added to it. The test screens for deficiencies and inhibitors of all factors, except factors VII and XIII.

Sodium is a major cation of extracellular fluid that maintains osmotic pressure and acid-base balance, and assists in the transmission of nerve impulses. Sodium is absorbed from the small intestine and excreted in the urine in amounts dependent on dietary intake.

Potassium is the most abundant intracellular cation that serves important functions such as regulate acid-base equilibrium, control cellular water balance, and transmit electrical impulses in skeletal and cardiac muscles.

Chloride is a hydrochloric acid salt that is the most abundant body anion in the extracellular fluid. Functions to counterbalance cations, such as sodium, and acts as a buffer during oxygen and carbon dioxide exchange in red blood cells (RBCs). Aids in digestion and maintaining osmotic pressure and water balance.

Magnesium is used as an index to determine metabolic activity and renal function. Magnesium is needed in the blood-clotting mechanisms, regulates neuromuscular activity, acts as a cofactor that modifies the activity of many enzymes, and has an effect on the metabolism of calcium.

Serum osmolality is a measure of the solute concentration of the blood. Particles include sodium ions, glucose, and urea. Serum osmolality is usually estimated by doubling the serum sodium because sodium is a major determinant of serum osmolality.

Phosphorus (Phosphate) is important in bone formation, energy storage and release, urinary acid-base buffering, and carbohydrate metabolism. Phosphorus is absorbed from food and is excreted by the kidneys. High concentrations of phosphorus are stored in bone and skeletal muscle.

Calcium (Ca+) is a cation absorbed into the bloodstream from dietary sources and functions in bone formation, nerve impulse transmission, and contraction of myocardial and skeletal muscles. Calcium aids in blood clotting by converting prothrombin to thrombin.

A urinalysis (UA), also known as routine and microscopy (R&M), is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds that pass through the urine. It has been a useful tool of diagnosis since the earliest days of medicine. The color, density, and odor of urine can reveal much about the state of health of an individual.

Normal urine color ranges from pale yellow to deep amber in color, depending on the concentration of the urine. The amount and kinds of waste in the urine make it lighter or darker. Pigments and other compounds in certain foods and medications may change the color of urine. Blood in the urine colors it; if the amount of blood in the urine is great, the urine will be red. During a flare-up of chronic nephritis, the small number of red blood cells present in the urine give it a smoky appearance.

The clean-catch urine method is used to prevent germs from the penis or vagina from getting into a urine sample. It is a method of collecting a urine sample for various tests, including urinalysis, cytology, and urine culture.

Explain to the patient that this kind of urine collection involves first voiding approximately one half of the urine into the toilet, urinal, or bedpan, then collecting a portion of midstream urine in a sterile container, and allowing the rest to be pass into the toilet. Discuss that this is done to detect the presence or absence of infecting organisms and, therefore, must be free from contaminating matter that may be present on the external genital areas.

The test does not require anything other than normal urination. There are no risks involved. Generally, the patient will be given one or more containers to collect and store urine over a 24-hour time period.

Example: Begin collecting the 24-hour urine specimen by voiding at 7:00 am and discarding the urine. Collect all urine voided during the next 24 hours. At 7:00 am the next morning, void and add the urine to the collection container. Keep the collection container refrigerated until delivery to the laboratory.

A pregnancy test measures a hormone in the body called human chorionic gonadotropin (HCG), a hormone produced during pregnancy. This hormone can be detected in small amounts in both the urine and the blood of a pregnant woman as early as 10 days after conception.

Allow patient to wait one to two weeks after her first missed period to get the most accurate results. Note: Irregular periods or miscalculations of when a period is due can affect the test. According to the FDA, 10 to 20 percent of pregnant women may not detect their pregnancy by testing on what they believe to be the first day of their first missed period.

Urea nitrogen is the nitrogen portion of urea, a substance formed in the liver through an enzymatic protein breakdown process. Urea is normally freely filtered through the renal glomeruli, with a small amount reabsorbed in the tubules and the remainder excreted in the urine. Elevated levels indicate a slowing of the glomerular filtration rate.

Conditions affecting the gastrointestinal tract can be easily evaluated by studying the normal laboratory values of alanine aminotransferase, aspartate aminotransferase, bilirubin, albumin, ammonia, amylase, lipase, protein, and lipids.

Alanine Aminotransferase (ALT) test is used to identify hepatocellular injury and inflammation of the liver and to monitor improvement or worsening of the disease. ALT was formerly known as serum pyretic transaminase (SGPT).

Aspartate Aminotransferase (AST) test is used to evaluate a client with a suspected hepatocellular disease, injury, or inflammation (may also be used along with cardiac markers to evaluate coronary artery occlusive disease). AST was formerly known as serum glutamic-oxaloacetic transaminase (SGOT).

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