PowerPoint® to accompany
Medical Assisting
Chapter 47
Second Edition
Ramutkowski Booth Pugh Thompson Whicker
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
1
Collecting, Processing and
Testing Urine Specimens
Objectives
471 Describe the characteristics of urine, including
its formation, physical composition, and
chemical properties.
472 Explain how to instruct patients in specimen
collection.
473 Identify guidelines to follow when collecting
urine specimens.
475 Explain the process of urinary catheterization.
2
Collecting, Processing and
Testing Urine Specimens
Objectives (cont.)
476 List special considerations that may require you
to alter guidelines when collecting urine
specimens.
477 Explain how to preserve and store urine
specimens.
478 Explain how to maintain the chain of custody
when processing urine specimens.
478 Explain how to preserve and store urine
specimens.
3
Collecting, Processing and
Testing Urine Specimens
Objectives (cont.)
479 Describe the process of urinalysis and its
purpose.
4710 Identify the physical characteristics present in
normal urine specimens.
4711 Identify the chemicals that may be found in
urine specimens.
4712 Identify the elements categorized and counted
as a result of microscopic examination of
urine specimens.
4
Introduction
Routine urine analysis
Simple, noninvasive
diagnostic test
provides a window
to the patient’s
health.
You will learn how to
correctly process a
specimen, including
a random specimen
and chain of custody
drug screen.
You will learn about various types of urine specimens and
how to properly instruct or assist patients with collection
of these specimens.
5
Role of the Medical Assistant
Help collect, process, and
test urine specimens.
You will need to know:
Anatomy and
physiology of kidney
How urine is formed
Normal urine contents
6
The Urinary System
Organs of the urinary system:
Kidneys
Ureters
Urinary bladder
Urethra
Click for larger view
Kidney function removes waste products from the
blood stream and excess water
Urinary bladder stores urine, and ureters, bladder
and urethra make up the urinary tract 7
The Urinary System
Urethra
Aorta
Kidneys
Liver
Urinary bladder
Left Ureter
Right Ureter
Prostate gland
8
Using the OnScreen Pen draw a line to each of the organs.
Formation of Urine
Three processes of The nephron:
urine formation: allows for
glomerular
filtration
tubular
reabsorption
tubular secretion
reabsorption of
water and
electrolytes
plays a vital role in
maintaining normal
fluid balance
9
Physical Composition and
Chemical Properties
Urine
95% water
5% waste products
Other dissolved chemicals
Urea, uric acid, ammonia, calcium,
creatine, sodium, chloride, potassium,
sulfates, phosphates, bicarbonates,
hydrogen ions, urochrome, urobilinogen
10
Apply Your Knowledge
Components of normal urine include:
A urea, uric acid and ammonia.
B chloride, potassium and sugar.
C red blood cells, sperm and H2O2
D hydrogen ions, urochrome, and uranium.
11
Apply Your Knowledge Answer
Components of normal urine include:
A urea, uric acid and ammonia.
B chloride, potassium and sugar.
C red blood cells, sperm and H2O2
D hydrogen ions, urochrome, and uranium.
12
Obtaining Specimens
General guidelines:
Follow the procedure
Use the type of specimen container indicated by the
lab
Label the specimen container before giving it to
patient
Explain the procedure to patient
Wash your hands before and after procedure
Complete all necessary paperwork
13
Specimens Types
Varies in method used and in time
frame in which to collect
specimen
Types of specimens:
Random
First morning
Clean catch midstream
Timed
24 hour
14
Specimens Types (cont.)
Random – most common, taken anytime of day
First morning – has a greater concentration of
substances, taken in morning
Clean catch midstream – genitalia is cleaned, urine is
tested for microorganisms or presence of infection
Timed – specific time of day, always discard first
specimen before timing
24 hour – used for quantitative and qualitative
analysis of substances
15
Catheterization
Urinary catheter –
Urinary catheter
plastic tube
inserted to provide
urinary drainage
Catheterization –
Catheterization
procedure during
which the catheter
is inserted
16
Catheterization (cont.)
Catheterization is used to:
Relieve urinary retention
Obtain a sterile urine specimen
Measure the amount of residual urine in the
bladder
Obtain urine specimen if patient cannot void
Instill chemotherapy
Empty bladder before and during surgery and
before some diagnostic examinations
17
Catheterization (cont.)
Drainage catheters
Indwelling urethral (Foley)
Retention catheter in the renal pelvis
Ureteral catheter
Drainage through a wound that leads to a
bladder
Splinting catheter
Placed to repair ureter and must remain in
place for a week
18
Catheterization (cont.)
Not routinely done because can cause
infection
Some states do not permit medical
assistants to perform catheterization
Usually done in physician's office for
diagnostic purposes
Specially prepared catheterization kits
have all necessary instruments and
supplies.
19
Apply Your Knowledge
A patient has returned to the office and is
complaining of not being able to empty her
bladder after her hysterectomy. The
physician has asked you do a catheterization
of her bladder. Why?
20
Apply Your Knowledge Answer
A patient has returned to the office and is
complaining of not being able to empty her
bladder after her hysterectomy. The
physician has asked you do a catheterization
of her bladder. Why?
Catheterization is used to empty a bladder if
the patient is unable to do so.
21
Chain of Custody
You may need to obtain urine specimens
for drug and alcohol analysis for
medicolegal matters
If procedure not followed exactly, you
have broken the chain and urine is not
admissible.
Thoroughly explain procedure and have
the patient sign consent form
22
Urinalysis
Evaluation of urine to obtain
information about body health
and disease
Three types of testing:
Physical
Chemical
Microscopic
23
Preservation and Storage
Changes that affect
the chemical or
microscopic
properties of urine
occur if urine is
kept at room
temperature for
more than 1 hour
Refrigeration – most
common method for
storing and preserving
urine
It prevents bacterial
growth for 24 hours.
After 24 hours use
chemical preservation
24
Normal Values of Urine
Normal values of various
elements have been
established
Average adult daily urine
output is 1250 mL/24 hours
Intake and output should be
approximately the same
25