DIAGNOSTIC TEST IN URINARY SYSTEM

By Dina Dewi S L I

URINE STUDIES (URINE TEST)

Tes Urin merupakan prosedur diagnostik pada urin yang bertujuan untuk melihat adanya gangguan pada ginjal atau saluran kemih Tes ini terdiri dari beberapa : Urinalysis Culture & Sensitivity Urin 24 jam Electrolite Protein Creatinine

THE NURSE
Check physician orders Keep it Simple directions to client Standard precautions Label specimen Timely Documentation

OBTAINING SPECIMEN
Wash hands Clean meatus, female front to back Start stream, then stop, collect specimen Aseptic technique Bedpan/mexican hat To lab 15-20min post collection

CHILDREN
Pediatric bags ( u Bag) Never squeeze diaper

SPECIMEN COLLECTION
1.

Random Specimens
Clean-not sterile Ordered for

Urinalysis testing Measurement of specific gravity pH Glucose levels

URINE SPECIMEN COLLECTION

2.

Midstream Specimen

Clean voided C&S 30-60 mls urine

Indwelling catheter Drainage bag

3.

Sterile Specimen

URINE COLLECTION
4.

Timed urine specimens

2-72 hr intervals (24hr most common) Begin after urinating Note start time on container & requisition Collect all urine in timed period

Post Reminder Signs

INDWELLING CATHETER

Strict aseptic technique Only from Bag if Brand new Sampling Port? Clamp 30 min. prior Wash hands Glove Cleanse port with alcohol swab Sterile needle To lab 30 min (may refridge 2hrs)

COMMON URINE LAB TESTS

Routine Urinalysis

Examine within 2hrs 1st voided specimen in AM Reagent strip Concentration 1.010-1.025
Diabetics Reagent strips Double void

Specific Gravity

Urine glucose

NORMAL VALUE OF URINE STUDIES

TEST Urinalisis NORMAL RESULT Warna, bau, BJ, pH, Protein, Glukosa, Keton, RBC, WBC, Bakteri EXPLANATION Biochemicak & mikroskopis NURSING RESPONSIBILITIES Midstream clean cacth tecnique. Memberikan KIE yang jelas tentang cara pengambilan urin. Menggunkan teknik steril pada klien dengan indwelling kateter Midstream clean cacth tecnique. Memberikan KIE yang jelas tentang cara pengambilan urin. Menggunkan teknik steril pada klien dengan indwelling kateter

Kultur & sesitivity No bacteria

Ditempatkan dalam medium dan di biakkan. Untuk sensitivity bakteri ditumbuhkan dlm media yang mengandung antibiotik

CONT
TEST Urin 24 Jam NORMAL RESULT EXPLANATION NURSING RESPONSIBILITY

Electrolyte Sodium Chloride Potasium Calcium

Magnesium

40-220 mEq/Hr 110-259 mEq/Hr 25-125mEq/Hr 100-300mg/24 Hr 7,3-12,2 mg/dL

Ekskresi elektrolit dalam urin tergantung pada intake. Data penunjang pada klien dengan gangguan renal, cairan & elektrolit, asambasa
Identifikasi penyakit ginjal

Mengambil specimen dan menentukan zat tambahan yang diperlukan sesuai dengan tes yang dilakukan. Menyimpan spesimen dalam refrigator.

Protein Creatinine

Rest: 50-80 mg/dL Amb : <150

DIPSTICK

RENAL FUNCTION TESTS

Renal

function tests are used to evaluate the severity of kidney disease and to assess the patients clinical progress. These tests also provide information on the effectiveness of the kidney in carrying out its excretory function

LABORATORY TEST
TEST Normal Value

BUN
Serum Creatinine

5-20 mg/dL, sedikit meningkat pada lansia

F: 0.5-1.1 md/dL M : 0.6-1.2 mg/dL Cenderung menurun pada lansia F : 88-128 mL/min M: 97-137 mL/min Cenderung menurun pada lansia

Cr Clearance

Serum albumin

3.2-5 g/dL 3.2-4.8 g/dL pada lansia

REFERENSI

Burke, Lemone, Mohn Brown. 2006. Medical Surgical Nursing Care. 2nd Ed. Australia: Pearson Education