Urinalysis (Multistix) Lab Procedure Sheet Why urinalysis is done Urinalysis is often used prior to surgery, as a preemptive screening during a pregnancy checkup, or as part of a routine medical or physical exam. Your doctor may also order urinalysis if she/he suspect that you have certain conditions, such as: diabetes kidney disease liver disease urinary tract infection If you’ve already been diagnosed with any of these conditions, your doctor may use urinalysis to check on the progress of treatments or the progression of a disease. Urinalysis carries no health risks, as you simply need to urinate in a cup. Your doctor may also want to do a urinalysis if you experience certain symptoms, including: abdominal pain back pain blood in the urine painful urination Preparing for urinalysis: Before your test, make sure to drink plenty of water so that you can give an adequate urine sample. You don’t have to fast or change your diet for the urinalysis test. Also, tell your doctor about any medications or supplements you’re taking. (Vitamin C supplements). Some illegal drugs can affect your results as well. Tell your doctor about any substances you use before doing a urinalysis. Collecting Urine Sample: You may be asked to obtain a clean catch urine sample. This technique helps prevent bacteria from the penis or vagina from getting in the sample. Begin by cleaning the genitalia around the urethra with a pre-moistened cleaning wipe that the doctor will provide. Urinate a small amount into the toilet, and then collect the sample in the cup. Avoid touching the inside of the cup so you don’t transfer bacteria from your hands to the sample. When you’re finished, place the lid on the cup and wash your hands. Color and Turbidity: Procedure1. Observe the specimen Normal urine is amber-yellow and clear to slightly cloudy o Concentrated urine is darker yellow. o Dilute urine is colorless. o White blood cells may make the urine cloudy. o Blood or bilirubin in the urine can give a red-brown color. Chemical Analysis Procedure: Many chemical tests can be performed on a small quantity of urine by using a dipstick. A dipstick is a piece of plastic to which pads of certain chemical reagents have been attached. Each pad will test for a particular substance in the urine. When the urine comes in contact with the reagents, a chemical reaction occurs which changes the color of the pad based upon how much of the substance is in the urine. The color of the pad is compared to a color chart and an approximate amount of the substance can be determined. 1. Mix urine well prior to testing. Samples not well mixed may give inaccurate results. 2. Remove one strip from container and REPLACE CAP. Replace cap immediately to avoid exposure to moisture to remaining strips. 3. QUICKLY IMMERSE reagent area of the strip COMPLETELY in fresh urine. Dip and remove immediately to avoid dissolving the reagent. 4. Remove excess urine by drawing edge of strip along the specimen container rim then blot edge of strip on a paper towel. Do not to touch pads on the paper towel. 5. Hold strip in a flat, horizontal position. This avoids possible mixing of dyes and chemicals from adjacent pads 6. Compare reagent pads to corresponding Color Chart on the bottle label. Hold the strip close to the color blocks and match carefully and reading pads from bottom (glucose) to top (Leukocytes). READ TIMES ARE CRITICAL. Some colors continue to intensify for a short time and then fade. Glucose- Normal urine does not have glucose. Glucose is a positive indicator for diabetes. May also result from excessive carbohydrate intake Bilirubin- Bilirubin can show liver disease. It is a pigment made in the liver from recycled red blood cells. Normal readings are negative. Ketones- Ketones are substances formed during fat breakdown. Ketones can be found in cases of starvation and diabetes. Normal urine has no ketones. Blood- Small amounts of blood in the urine is normal. Large amounts can be due to trauma, urinary tract infections and blood clotting problems. pH- This number shows how acidic or alkaline the urine is. Normal pH- 5.5 – 7.0 Higher pH levels can be a sign of infection Protein- Healthy person usually does not have protein in their urine. Protein can be an indication of kidney problems ( Urobilinogen- Normal results show small amounts of urobilinogen. It is produced by intestinal bacteria. Nitrates- Produced by bacteria during infections. Normal readings are negative. May indicate bacterial contamination or urinary tract infection Table 1: Laboratory Correlations of Urine Dipstick Results with Clinical Conditions Test Glucose Bilirubin Ketone Specific Gravity Blood pH Protein Nitrite Leukocytes Clinical Conditions Diabetes mellitus Impaired tubular re-absorption Pregnancy with possible gestational diabetes mellitus Hepatitis Cirrhosis Gallbladder duct blocked Diabetes Mellitus (ketoacidosis) Starvation Patient hydration and dehydration Loss of renal tubular concentrating ability Diabetes insipidus Bladder infection (cystitis) Kidney infection (pyelonephritis) Kidney stones High blood pressure Enlarge prostate Respiratory or Metabolic Acidosis Respiratory or Metabolic Alkalosis Defects in renal tubular secretion and reabsorption Glomerular membrane damage Impaired tubular re-absorption Multiple myeloma Orthostatic or postural proteinuria Cystitis Pyelonephritis Monitoring of patients at high risk for urinary tract infection Screening of urine culture specimens Urinary tract infection Screening of urine culture specimens
