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Urine dipstick urinalysis (Protein (Expected result: Negative / trace,…
Urine dipstick urinalysis
Definition:
A urine dipstick urinalysis measures the content of the urine to detect and/or manage a wide range of medical diagnosis. It provides the composition of the urine and indicates how effectively the kidneys are processing waste.
A urine dipstick will change colour if certain substances are present including proteins, ketones, hemoglobin, nitrates and other harmful pathogens
A urine dipstick is a convenient test that provides an instant result, but can provide false-positive and false-negative results.
Leukocytes
Expected result: Negative
The detection of white blood cells in the urine suggest a possible
UTI
in the urinary tract such as the bladder or urethra
Leukocytes in the urine may also be a sign of a
kidney infection
.
A large result of leukocytes may mean
kidney stones
,
pelvic area tumor
, or a
blockage
in the UT.
Nitrates
Expected result: Negative
This screens for possible asymptomatic infections caused by nitrate-reducing bacteria.
Suggests a possible
UTI
Urobilinogen
Measures the amount of urobilinogen in urine. This is a breakdown product of bilirubin and is formed from the reduction of bilirubin of which helps breaks down red blood cells.
Little or nil urobilinogen can suggest a possible deterioration of liver functions.
Positive test results can indicate
liver disease
i.e. cirrhosis, viral hepatitis, liver damage
Expected result: less than 17
Protein
Expected result: Negative / trace
This screens for acute and chronic
kidney disease
. Protein can be excreted in the urine which suggests the kidneys may not be work properly, or when high levels are present in the bloodstream.
Protein in urine= Proteinuria or Albuminuria
Low levels of protein= normal / not a cause for concern
Kidneys prevent significant amounts of protein from entering the urine.
Proteinuria (Albuminuria) is associated with early renal disease
Positive result can indicate infection, diabetes, trauma
Blood
Expected result: Negative
Blood in urine is called hematuria
Hematuria can include
UTI
,
kidney infection
,
medication
,
strenuous exercise
,
kidney/bladder stones
False-positive due to menstrual contamination may be seen
Ketone
Expected results: Negative / none
The cells use glucose for energy. When cells do not receive enough glucose the body therefore burns fat instead. As a result Ketones is produced which can show up in urine.
Ketones (ketonuria) indicated on a urine dipstick could be a sign of diabetes.The control of urinary ketones is useful in managing and monitoring type 1 diabetes
Ketones in healthy individuals are formed in the liver and are metabolised. This means a very low amount will appear in the urine. However, higher levels of ketones indicate that the body is using fat as the major source of energy.
Altered carbohydrate and fat metabolism in diabetes and starvation. also present in dehydration, vomiting, and severe diarrhea
pH
Expected result: low
Normal: 4.5-8
pH indicates the amount of acid in the urine.
Abnormal pH may indicate kidney/UT disorder or kidney stones.
Control of diet will regulate pH. Diet rich in animal proteins tend to produce acidic urine and diets composed of vegetables produce alkali urine.
abnormal finding >8.0
Glucose
Expected results: Negative / none
Glucose in urine can indicate diabetes
Most glucose is filtered by the kidneys and then reabsorbed. Glucose may spill into the urine if the amount of glucose present exceeds kidney's capacity to reabsorb.
High levels can indicate uncontrolled diabetes
Dipstick indicators of infection:
pH
Leukocyte
Nitrite
Hemoglobin
Non-infectious dipstick:
Protein
Glucose
Ketones
Bilirubin
Patient A
The Doctor had requested a urine dipstick for Patient A (25 year old female) due to the following symptoms:
Lower back pain
Burning sensation when urinating
Frequent urge to void
Cloudy urine
Nursing management:
Plan:
1.
Relief from troublesome
2.
Prevention from further damage of upper urinary tract
3.
Prevention of recurrence
Diagnostic studies:
Abnormal urine dipstick findings:
Leukocytes (white blood cells)
Nitrites (indicating bacteriuria)
Based on subjective and objective data Patient A has a urinary tract infection
This is inflammation of the urinary tract.
Health promotion:
Health promotion activities can decrease the frequency of infections and provide for early detection of infection.
Activities include:
Emptying the bladder regularly and completely
Emptying the bowel regularly
Wiping from front to back after urination and defecation
Drinking an adequate amount of liquid
Taking cranberry capsules or drinking cranberry juice
Increase fluid intake: This will increase frequency of urination but will also dilute the urine making the bladder less irritable. Fluids also help flush out bacteria
Take all antibiotics as prescribed
Patient B
The Doctor has requested a urine dipstick for Patient B (35 year old Male) who had the following symptoms:
Mild fatigue
Sudden onset of chills
Fever
Vomiting
Flank pain
Febrile (37.9 degrees)
Diagnostic studies:
Abnormal urine dipstick results:
Leukocytes
Hematuria
Objective and subjective data suggests Patient B to have Acute pyelonephritis
This is inflammation of the renal parenchyma and collecting system i.e. kidney infection.
Nursing Management:
Plan:
1.
Promote normal renal function
2.
Normal body temperature
3.
relief of pain
4.
No recurrence of pain
Nursing Implementation:
This includes health promotion and maintenance measures, Early treatment can prevent ascending infections
Health promotion
This involves teaching patients about the disease process by:
Continuing medications as prescribed
Having a follow-up urine culture
Recognising symptoms
Encouraging them to drink at least 8 glasses of water per day