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General Laboratory: Urinalysis: Basic Overview Online Training

This course will introduce you to the importance of urine testing in order to detect various disease states. 

Continue Button Untitled Scene Master Template HOOD05162003052540 | Effective Date: 26-Nov-2019 ? Urinalysis: Basic Overview Online Training This course will introduce you to the importance of urine testing in order to detect various disease states. Identify reasons for analyzing urine 1 Identify disease states that can be recognized by urinalysis 3 Identify important steps performed in the analysis of urine 2 Welcome urinalysis_basicoverview_welcome.mp3 Welcome to the urinalysis basic overview online training course. Urine testing provides clinicians with valuable information to aid in the detection of various disease states. Such testing is useful not only in detecting individuals who have some clinical abnormality, but also in confirming normal urinalysis in the majority of individuals who do not have detectable disease. In this course you will learn about the procedures and methods used in performing routine analysis of urine samples. ? What is Urine? Urine is a yellowish, slightly acid, fluid waste product that is: Produced by the kidneys as blood flows through microscopic filtering structures Composed of water and chemical components filtered from blood Passed through the urinary tract and eliminated from the body Select the tab arrows to learn more about the components of the urinary tract. Kidney Ureters Bladder Urethra What Is Urine? urinalysis_basicoverview_whatisurine.mp3 Base layer audio: Urine is a yellowish, slightly acid, fluid waste product normally excreted by the kidneys. The kidneys produce urine as blood flows through microscopic structures called nephrons. Water and chemical components from the blood pass through the blood vessel walls and then through a complex tubular system in the kidney which selectively excretes or retains various substances according to specific body needs. Urine formed by the kidney passes through other structures in the urinary tract before it is eliminated. urinalysis_basicoverview_kidney.mp3 Kidney layer audio: Urine formed by the numerous kidney nephrons is drained into the center of the kidney and then excreted into the ureter. urinalysis_basicoverview_ureter.mp3 Ureter layer audio: The ureter is the long duct or tube that conveys the urine from the kidney to the bladder. urinalysis_basicoverview_bladder.mp3 Bladder layer audio: The bladder is the sac-shaped muscular organ that stores the urine secreted by the kidneys. urinalysis_basicoverview_urethra.mp3 Urethra layer audio: The urethra is the canal through which urine is discharged from the bladder and through which semen is discharged in males. Urethra The urethra is the canal through which urine is discharged from the bladder and through which semen is discharged in males. Bladder The bladder is the sac-shaped muscular organ that stores the urine secreted by the kidneys. Ureters The ureters are the long ducts or tubes that conveys the urine from the kidneys to the bladder. Kidneys Urine formed by the numerous kidney nephrons is drained into the center of the kidney and then excreted into the ureter. ? Analyzing Urine Analysis of urine is common and routine: Samples are easy to obtain and non-invasive Urinalysis can effectively evaluate kidney status Urinalysis is a good frontline test Urinalysis can aid or supplement the diagnosis of disease A routine urinalysis collected in a doctor's office or in a hospital can detect important substances such as protein and blood that begins to appear in urine before the patient is even aware of a problem. Analyzing Urine urinalysis_basicoverview_analyzingurine.mp3 Analysis of urine is a common and routine testing procedure ordered by physicians. Urine samples are easy to obtain and are non-invasive to the patient. Urinalysis is an effective means of evaluating kidney status and has been called a “fluid biopsy of the kidney.” It is also a good frontline test. Since the composition of urine is directly affected by components in the blood, urinalysis is an easy and cost-effective way to initially evaluate overall patient health. Finally, urinalysis can also aid or supplement the diagnosis of diseases and be used to confirm conditions diagnosed by other more invasive or costly diagnostic procedures. ? Urine Sample Types There are four urine sample types that can be collected: Random First morning Catheterized 24 Hour Select the tab arrows to learn more about the four types of urine samples. Random First Morning Catheterized 24 Hour Urine Sample Types urinalysis_basicoverview_urinesampletypes.mp3 Base layer audio: Several types of urine samples can be collected depending on the specific diagnostic need including random, first morning, catheterized, and 24 hour samples. urinalysis_basicoverview_random.mp3 Random layer audio: This sample is a portion of a single voided urine without defining the volume, time-of-day, or detail of patient preparation. While the most convenient and common type of specimen for routine analysis, it is also associated with many false negative and some false positive results. The specimen is good for routine chemical screens and microscopic examinations. urinalysis_basicoverview_firstmorning.mp3 First morning layer audio: This specimen is voided immediately after an overnight bed rest before breakfast and other activities. This has been traditionally recommended as the standard specimen for routine urinalysis, because it is more concentrated than the day urine and allows time for possible bacterial growth in the urinary bladder. urinalysis_basicoverview_catheter.mp3 Catheterized layer audio: This is a urine specimen obtained using a sterile catheter (a flexible tube) inserted through the urethra and into the bladder. Urine flows directly from the bladder and is collected in a plastic reservoir bag. This specimen type is collected when a sterile urine specimen is required for testing. urinalysis_basicoverview_24hour.mp3 24 hour layer audio: In this type of specimen, all urine produced during a 24 hour period is collected and preserved in a manner appropriate for the analyte(s) being tested. The collection can begin at any time of the day by emptying the bladder and noting the time. This specimen is typically used for specialized urine testing often performed by the chemistry or special chemistry laboratory. 24 Hour In this type of specimen, all urine produced during a 24 hour period is collected and preserved in a manner appropriate for the analyte(s) being tested. The collection can begin at any time of the day by emptying the bladder and noting the time. This specimen is typically used for specialized urine testing often performed by the chemistry or special chemistry laboratory. Catheterized Sample This is a urine specimen obtained using a sterile catheter (a flexible tube) inserted through the urethra and into the bladder. Urine flows directly from the bladder and is collected in a plastic reservoir bag. This specimen type is collected when a sterile urine specimen is required for testing. First Morning Sample This specimen is voided immediately after an overnight bed rest before breakfast and other activities. This has been traditionally recommended as the standard specimen for routine urinalysis, because it is more concentrated than the day urine and allows time for possible bacterial growth in the urinary bladder. Random Urine Sample This sample is a portion of a single voided urine without defining the volume, time-of-day, or detail of patient preparation. While the most convenient and common type of specimen for routine analysis, it is also associated with many false negative and some false positive results. The specimen is good for routine chemical screens and microscopic examinations. ? Urine Analysis Steps The following steps are taken to analyze urine samples: Sample collection Sample handling and transport Performance of routine urinalysis Urine Analysis Steps urinalysis_basicoverview_analysissteps.mp3 Let’s now take a look at important steps in the process of analyzing a urine sample. We will look at sample collection, proper sample handling and transport, and the procedure of performing routine urinalysis. ? Clean-Catch Midstream Sample A clean-catch midstream sample includes an additional patient preparation step. It is collected in order to minimize contamination of the sample by bacteria, blood, or other contaminants present on the internal and external genitalia. The procedure consists of the following steps: Wash hands well Use an antiseptic towelette to wipe genitalia thoroughly Start urinating into toilet Collect the urine specimen (do not touch the inside of the container) Finish urinating into the toilet Place the cap on the container This procedure is especially important when urine is to be cultured for bacterial content. In this case the specimen is also collected in a sterile container equipped with a tight-fitting, sterile cap. Clean-Catch Midstream Urine Sample urinalysis_basicoverview_cleancatch.mp3 A clean-catch midstream sample includes an additional patient preparation step. It is collected in order to minimize contamination of the sample by bacteria, blood, or other contaminants present on the internal and external genitalia. The procedure consists of the following steps: Wash hands well Use an antiseptic towelette to wipe genitalia thoroughly Start urinating into toilet Collect the urine specimen (do not touch the inside of the container) Finish urinating into the toilet Place the cap on the container This procedure is especially important when urine is to be cultured for bacterial content. In this case the specimen is also collected in a sterile container equipped with a tight-fitting, sterile cap. ? Sample Handling and Transport To help minimize urine sample to degradation: Analyze within 2 hours if possible Refrigerate at 4° C Use preservatives only as necessary Minimize exposure to light Sample Handling and Transport urinalysis_basicoverview_handlingandtransport.mp3 Urine samples are subject to degradation which can affect test results. Urine should be examined and analyzed within one to two hours after voiding. If this cannot be done, then refrigeration at 4° C is preferred to minimize bacterial growth and preserve cellular elements. Preservatives should be used cautiously, as they may be suitable for some test procedures but may interfere with others. In some cases it may also be important to protect the sample from light exposure that may cause breakdown of some chemical components. ? Performing Routine Analysis Routine Urinalysis steps include: Determining physical characteristics Performing chemical testing Determining the presence of cellular and formed elements Performing additional confirmatory testing Note: The chemistry and special chemistry laboratories also use urine samples to perform special testing for individual chemical components. The microbiology laboratory performs urine cultures to isolate and identify infecting organisms of the urinary tract and determine their susceptibility to antibiotics. Select the numbered steps below to learn more about routine urinalysis steps. 1 1 1 2 2 2 3 3 3 4 4 4 5 5 5 6 6 6 Performing Routine Analysis urinalysis_basicoverview_confirmatorytesting.mp3 Base layer audio: Although many different tests are performed on urine, we will concentrate on the most common urine test in the clinical laboratory – the Routine Urinalysis. This panel of tests includes analysis of the physical characteristics of the sample such as color and clarity, testing for various chemical components, detecting the presence of formed or cellular elements in the sample, and finally, performing any confirmatory procedures. urinalysis_basicoverview_physicalcharacteristics.mp3 Physical characteristics audio: The first component in routine urinalysis to evaluate the samples physical characteristics. Physical characteristics can change with the composition and age of the urine sample. Physical characteristics include color, clarity, volume and specific gravity. urinalysis_basicoverview_chemicaltesting.mp3 Perform chemical testing layer audio: Next, testing for various chemical components is typically done by using urinalysis multi-test reagent strips. These strips contain pads impregnated with different reagents specific for the analytes of interest. urinalysis_basicoverview_testpads.mp3 Test pads layer audio: When urine comes in contact with the test pad, the reagent and analyte will react and the pad will change color depending on the concentration of the analyte. The color change of the pad can either be read visually or by an automated or semi-automated instrument. urinalysis_basicoverview_routineanalysis.mp3 Routine urinalysis tests audio: It is important to note that routine tests and any other tests performed on a random specimen of urine are qualitative or semi-quantitative, not quantitative. This means that only an approximate amount of analyte excreted by the kidney is measured. At best, only a concentration range of the analyte in the tested specimen is estimated, but never the total amount excreted. Quantitative results are determined in follow-up confirmatory testing only if the urine is collected over a precisely measured period of time and the concentration is calculated based upon the total volume of urine excreted. urinalysis_basicoverview_cellular.mp3 Cellular and formed elements layer audio: The next component of routine urinalysis is to determine the presence of cellular and formed elements in the specimen. Cellular elements in urine can include red blood cells, white blood cells, epithelial cells, sperm, yeast or parasites, and bacteria. Formed elements include crystals and casts. Analysis of formed and cellular elements is done either manually by microscopic observation or automatically by an automated analyzer. urinalysis_basicoverview_additionalconfirmatory.mp3 Additional confirmatory testing layer audio: Confirmatory tests are used when the results of the routine urine analysis are unexpected or inconsistent with the clinical diagnosis or other test results. General approaches to confirmatory testing include: repeating the test on the same specimen along with a positive and negative control sample, using a different test method for the analyte, collecting and testing a new specimen, gathering additional information such as testing the urine for another component, conducting a relevant serum test, or collecting further information from the patient. Performing Additional Confirmatory Testing Follow the steps below to perform additional confirmatory testing: Repeat the test along with a positive and negative control sample Use a different test method for the analyte Collect and test a new specimen Gather additional information about the specimen or patient 6 Determination Cellular and Formed Elements Cellular elements include: Red blood cells White blood cells Epithelial cells Sperm Yeast Parasites Bacteria Formed elements include: Crystals Casts 5 Routine Urinalysis Tests Routine urinalysis tests are qualitative or semi-quantitative. Quantitative results can only be determined if: Urine is collected over a precisely measured period of time Analyte concentration is calculated based upon the total volume of urine 4 Test Pads Test pads change color depending on the concentration of analyte in the urine. 3 Perform Chemical Testing Testing for specific analytes is performed using multi-test reagent strips. Some common analytes include: pH Glucose Bilirubin Nitrite Blood Urobilinogen Albumin Protein Ketones Leukocyte Esterase Creatinine Specific Gravity 2 Evaluate Physical Characteristics Physical characteristics include: Color Clarity Volume Specific Gravity 1 ? Disease States The analysis of urine can be key in the detection of several disease states from infections to liver disease. Select the tab arrows to learn more about disease states. Diabetes Kidney Disease Urinary Tract Infection Liver Disease Disease States urinalysis_basicoverview_diseasestates.mp3 Base layer audio: The analysis of urine can be key in the detection of several disease states from infections to liver disease. Click each tab to learn more about the disease states that can be identified by a urinalysis. urinalysis_basicoverview_diabetes.mp3 Diabetes layer audio: Urine glucose level may detect undiagnosed diabetes and is an easy way to help monitor blood glucose levels. Urine ketone levels assess the severity of diabetes and avoid progressive diabetic ketosis, which can eventually lead to coma and even death. urinalysis_basicoverview_kidney.mp3 Kidney disease layer audio: Changes in urine specific gravity, increases in urine protein, and the presence of casts, blood, white cells or abnormal epithelial cells can indicate various types of kidney problems including kidney failure, inflammation, tumors, stones or infection. urinalysis_basicoverview_uti.mp3 UTI layer audio: The presence of blood, white cells and bacteria in the urine can indicate infection in the kidneys, ureters, bladder or urethra. Urinary tract infection is often referred to as a UTI. urinalysis_basicoverview_liver.mp3 Liver disease layer audio: Increased levels of bilirubin and/or urobilinogen in urine are used to diagnose and differentiate between liver and gall bladder disease. Liver Disease Increased levels of bilirubin and/or urobilinogen in urine are used to diagnose and differentiate between liver and gallbladder disease. Urinary Tract Infection The presence of blood, white cells and bacteria in the urine can indicate infection in the kidneys (1), ureters (2), bladder (3), or urethra (4). Urinary tract infection is often referred to as a "UTI.” Kidney Disease Changes in urine specific gravity, increases in urine protein, and the presence of casts, blood, white cells or abnormal epithelial cells can indicate various types of kidney problems including kidney failure, inflammation, tumors, stones or infection. Diabetes Urine glucose level may detect undiagnosed diabetes and is an easy way to help monitor blood glucose levels. Urine ketone levels assess the severity of diabetes and avoid progressive diabetic ketosis, which can eventually lead to coma and even death. ? Course Review Congratulations. You have completed the Urinalysis: Basic Overview Online Training course. Select the numbered buttons below to review the material before proceeding to the final assessment. Identify disease states that can be recognized by urinalysis Identify important steps performed in the analysis of urine Identify reasons for analyzing urine 1 1 2 2 2 3 3 3 Course Review Identify Disease States That Can Be Recognized By Urinalysis The following disease states can be recognized by urinalysis: Diabetes Kidney Disease Urinary Tract Infection Liver Disease Identify Important Steps Performed In the Analysis Of Urine Important analysis steps are: Sample collection: Samples can be random, first morning, catheterized, or 24 hour. A clean-catch midstream sample will minimize contamination from bacteria and extraneous elements Sample handling and transport: Urine samples should be analyzed in a timely manner or refrigerated to help inhibit degradation. Protection from light or use of a preservative may also be appropriate Performing Routine urinalysis: Determine physical characteristics Perform chemical testing Determine the presence of cellular and formed elements Perform additional confirmatory testing Identify Reasons For Analyzing Urine Analysis of urine is common and routine: Samples are easy to obtain and non-invasive Urinalysis can effectively evaluate kidney status Urinalysis is a good frontline test Urinalysis can aid or supplement the diagnosis of disease A routine urinalysis collected in a doctor's office or in a hospital can detect important substances such as protein and blood that begins to appear in urine before the patient is even aware of a problem. Disclaimer Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthcare GmbH 2021 Siemens Healthineers Headquarters\Siemens Healthcare GmbH\Henkestr. 127\ 91052 Erlangen, Germany\Telephone: +49 9131 84-0\siemens-healthineers.com ? Disclaimer Assessment This assessment will test your retention of the presented content. A passing score of 80% or higher is required to complete the course and earn your certificate. You may repeat the assessment as many times as needed. Start ? Assessment Select the best answer. ? Question 1 of 5 How quickly after a urine specimen has been collected should the urinalysis be performed? Within 2 hours unless refrigerated Within 24 hours if kept at room temperature Within 1 week if frozen Chemical testing must be done immediately Multiple Choice Incorrect It is not always possible to test urine immediately. Incorrect Freezing the specimen could lead to degradation. Incorrect Specimens kept at room temperature are at risk of contamination. Incorrect Select the best answer. ? Question 2 of 5 During a routine visit to the doctor for your annual physical, he orders a routine urinalysis. What is the most likely reason for doing this? It is cost-effective and an easy way to initially evaluate your overall health If a urinalysis is ordered, a blood test would not be required The doctor wants to confirm a diagnosis Multiple Choice Incorrect Urinalysis test strip results are not used to confirm diagnosis. Incorrect Urinalysis does not replace blood testing. Incorrect Select the best answer. ? Question 3 of 5 What type of sample is collected at 3:30pm? Random sample Catheterized sample First morning sample 24 hour sample Multiple Choice Incorrect The 24 hour sample consists of all urine produced during an entire 24 hour period. It is often preserved and used to test for specific analytes. Incorrect The first morning sample is not taken in the middle of the afternoon. Incorrect This type of sample is collected through a tube inserted in the urethra. Incorrect Select the best answer. ? Question 4 of 5 What steps must be taken to inhibit degradation after labeling? The sample is stored in the refrigerator A preservative is added to the sample The sample is heated to keep at body temperature The sample is frozen Multiple Choice Incorrect Freezing the sample could damage the formed elements. Incorrect Heating the sample would cause bacteria to grow and cause false test results. Incorrect Preservatives are used cautiously in urine since they can interfere with some test results. Incorrect Select the best answer. ? Question 5 of 5 Confirmatory testing is performed when the results of the routine are: Inconsistent with other test results Quality not sufficient Negative for protein Consistent between strip and microscopic Multiple Choice Incorrect Results that are in agreement usually do not require confirmatory testing. Incorrect Normal results do not require confirmation. Incorrect If QNS, there is not enough specimen to perform any testing. Incorrect Assessment Results YOUR SCORE: PASSING SCORE: Review Retry Retry Continue Continue Continue %Results.ScorePercent%% %Results.PassPercent%% ? Assessment Results You did not pass the course. Take time to review the assessment then select Retry to continue. Congratulations. You passed the course.. Exit To access your Certificate of Completion, select the Launch button drop down on the course overview page. You can also access the certificate from your PEPconnect transcript. ? You have completed the Urinalysis: Basic Overview Online Training. Completion Navigation Help Select the icon above to open the table of contents. Click Next to continue. Next Welcome Slide The timeline displays the slide progression. Slide the orange bar backwards to rewind the timeline. Click Next to continue. Next Timeline Select the CC icon to display closed captioning (subtitles). Click Next to continue. Next Caption Icon add subtitles Select the buttons to learn more about a topic. Be sure to review all topics before navigating to the next slide. Click Next to continue. Next Tab Arrow Slide Select the X to close the pop-up. Click Next to continue. Next Layer Slide Select Submit to record your response. Click the X in the upper right corner to exit the navigation help. Assessment Slide Question Bank 1 HILS2202 | Effective Date: 20-APR-2021 1.1 Welcome 1.2 What Is Urine? 1.3 Analyzing Urine 1.4 Urine Sample Types 1.5 Urine Analysis Steps 1.6 Clean-Catch Midstream Urine Sample 1.7 Sample Handling and Transport 1.8 Performing Routine Analysis 1.9 Disease States 1.10 Course Review 1.11 Disclaimer 1.12 Assessment 1.19 Completion

  • urinalysis
  • general
  • laboratory
  • healthcare
  • diabetes
  • kidney
  • liver
  • disease
  • urinary
  • tract
  • infection