Chapter 44
Urinalysis
Blood Type Questions
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What is an antigen?
What is an antibody?
What happens in agglutination? Why can it be deadly?
A patient with type A blood needs a blood transfusion.
Identify the blood types that are compatible with hers.
TRUE OR FALSE…
______ Type O blood is considered to be a universal
donor.
______ Agglutination is a form of blood clotting in the
body.
______ An individual who has no antigens attached to
the membrane of their RBC are referred to as blood
type O.
______ A person with blood type AB is considered to be
a universal donor.
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12/8/15
 Objective: Identify the various tests used in the clinical
examination of urine
 Standard: Evaluate data from research articles
encompassing the reliability of home testing kits (i.e.,
pregnancy test) and portable diagnostic equipment (i.e.,
glucometers).
 Medical Minute: Define anuria, dysuria, polyuria,
hematuria, proteinuria, nocturia – Begin reading chap
44 in PMA book
 Turn in blood types homework and open book quiz to
tray in the back!
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Learning Objectives
 Understand the basic structures of the
urinary system
 Describe the importance of urinalysis
 Explain the importance of medical
terms related to the urinary system
 Explain the importance of the different
methods of urine collection
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Learning Objectives
 Explain and educate the patient in the proper
method of urine collection
 Identify the various tests included in the
physical and chemical examination of urine
 Explain the basis for urine pregnancy testing
 Recognize the basic structures or elements
that may be found in normal and abnormal
urine under the microscope
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Urinary System Structures
 Kidneys—filter waste
from blood, regulate
water, electrolyte,
and acid–base
content of blood,
production of urine
 Ureters—tubes
carrying urine from
kidneys to bladder
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Urinary System Structures
 Urinary bladder— collects urine and
stores until released from body
 Urethra—tube connecting bladder to
outside of body
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Characteristics of Urine
 Urine is sterile inside of body
 Urine becomes contaminated when
released from the body
 Urine is 95% water, 5% organic and
inorganic wastes
 Humans typically produce 1,000–1,500
ml urine in 24 hours
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12/9/15
 Objective: Identify the various tests used in the clinical
examination of urine
 Standard: Evaluate data encompassing the reliability of
home testing kits (i.e., pregnancy test) and portable
diagnostic equipment (i.e., glucometers).
 Medical Minute: Define turbid, specific gravity, and renal
threshold
 Sit in assigned seats! 
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Urine Collection Procedure
Instruct patient
Use proper collecting containers
Label correctly
Determine if specimen is adequate
amount for test
 Test specimen within 30–60 minutes,
refrigerate up to 8 hours
 Gently mix before testing
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Preparation for Urinalysis
 Medical assistant should familiarize self
with equipment:
 Reagent strip—color pads dipped
into urine
 Analyzer—automated machine to
read reagent strip
 Quality control—assures accuracy
of testing
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Reagent Strip
 Test strip contains
individual color pads
that correlate with a
urine component
such as glucose or
blood
 After dipping urine,
color is compared to
chart
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Analyzer
 Computer printout of
reagent strip
 Abnormal values are
flagged
 Can do more
urinalysis in short
period of time
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Urinalysis
 Three components to urinalysis:
 Physical—CLIA waived test
 Chemical—CLIA waived test
 Microscopic—CLIA non-waived test
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Urine color changes
 Foods
 Carrots – orange
 Beets – red tinged
 Blackberries – red tinged
 Vitamins
 Vitamin C or B - bright yellow/orange
 Medications
 Certain antibiotics – yellowish brown
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12/10/15 Medical Minute
Finish review questions and turn in!
 What is the function of the kidneys, ureters,
bladder and urethra?
 How much urine does a person normally produce
in one day?
 Describe 3 types of urine specimens.
 Identify the hormone present in urine if a female is
pregnant
 Describe reasons for the color of urine to be
abnormal
 Provide 2 examples of the physical components of
urine and 2 examples of the chemical components
of urine. What does it mean if they are abnormal?
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12/10/15
 Objective: Identify the various tests used in the
clinical examination of urine
 Standard: Evaluate data encompassing the
reliability of laboratory testing kits (i.e., pregnancy
test) and portable diagnostic equipment (i.e.,
glucometers).
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Chemical Components of
Urine
 Protein—protein may be present
temporarily
 If present referred to as proteinuria
 Can be caused by fever, stress, or
strenuous exercise
 Chronic proteinuria may be due to renal
failure
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Chemical Components of
Urine
 Ketones—by-products of fat metabolism
 should not be present in urine
 If present referred to as ketonuria
 Can result from starvation, high fat
diet, pregnancy, or diabetes
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12/11/15
Medical Minute:
All of the following medical terms represent the presence
of a substance in the urine EXCEPT:
A)
polyuria
B)
ketonuria
C)
hematuria
D)
glycosuria
Which of the
A)
B)
C)
D)
following is the function of the ureters?
filters waste materials from the blood
discharges urine to outside the body
carries urine from kidneys to the bladder
received urine from the kidneys
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12/11/15
 Objective:
 Identify the various tests used in the clinical
examination of urine.
 Assess clinical symptoms related to renal
dysfunction.
 Standard: Evaluate data encompassing
the reliability of laboratory testing kits
(i.e., pregnancy test) and portable
diagnostic equipment (i.e.,
glucometers).
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Urine Specimens
 Random urine specimen—most common
type of urine specimen, used for routine
screening
 First-morning urine specimen—most
concentrated specimen
 Clean-catch midstream urine specimen
(CCMS)—proper collection technique is
necessary, used for urine culture
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Urine Specimens
 Catheterized urine specimen—catheter
is placed into bladder to collect sterile
urine – ASEPTIC technique
 Suprapubic aspirate urine specimen—
syringe used to directly collect urine
 Sometimes used on pediatric patients
 Provides sterile specimen
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Physical Components - Color
 urochrome (pigment), varies due to
dilution or concentration of urine
 1st urine in the morning tends to be
darker
 Orange/brown – liver disease
(hepatitis)
 Red – UTI, trauma, renal disorder
 Milky – UTI
 Certain foods can change the color of
urine as well
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Physical Components - Clarity
 Clarity—appearance or transparency of
urine
 Fresh urine is usually clear or transparent
 Mucus, bacteria, and cells can contribute to
the cloudy appearance of urine
 Terms to use: clear, cloudy, slightly cloudy,
or turbid
 Turbid – thick or opaque
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Physical Components of Urine
 Odor—varying odors, not generally recorded
 Specific gravity— measures concentration of
dissolved substances in urine, varies according
to dilution or concentration of urine
 Normal is 1.005-1.030
 Concentrated urine has a higher specific
gravity
 Dehydration, heart disease, renal disease and
diabetes
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Chemical Components of
Urine
 pH—measures acidity or alkalinity of
urine
 Scale 0.0–14.0
 0.0–6.0 is acidic
 could indicate diabetes or starvation
 8.0–14.0 is alkaline
 could indicate a UTI
 Normal range for urine is 4.5-8.0
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Chemical Components of
Urine
 Glucose—no glucose should be present
in urine
 If present referred to as glycosuria
 Normally the kidneys will filter and
reabsorb glucose back into the
bloodstream
 Main cause of glucose in the urine is
diabetes
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Chemical Components of
Urine
 Blood—not normally found in urine
 Can be found as a contaminant during
menstruation
 Graded as negative, trace, small,
moderate, or large
 If found can indicate trauma, UTI, or
kidney stones
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Chemical Components of
Urine
 Leukocytes—should not be present in
urine
 If present suggests infection (UTI)
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Objective
 Identify the various tests used in the clinical
examination of urine.
 Assess clinical symptoms related to renal
dysfunction.
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Group Time
 Find your partner, and continue reading
the case studies
 Come up to each station to assess your
patients.
 Work on Case Study 3 while others are
rotating through the stations.
TURN IN CASE STUDIES AT THE END
OF CLASS!
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Further Expansion
 What are the chemical components of
urine?
 Describe what abnormal values can
indicate.
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12/11/15 Exit Ticket
Identify two components of urine
assessed in the urinalysis.
Turn in to the blue basket!
Have a great weekend 
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