Nursing Considerations for Routine

Urinalysis
by Byron Webb Romero, RN, MSN May 9, 2011
It is an essential procedure for patients undergoing hospital admission or physical
examination.
It is a useful indicator of a healthy or diseased state and has remained an integral part of
the patient examination.
Two unique characteristics of urine specimens can account for this continued popularity:
o Urine is a readily available and easily collected specimen.
o Urine contains information about many of the bodys major metabolic functions.
The process of urinalysis determines the following properties of urine: color, odor,
turbidity, specific gravity, pH, glucose, ketones, blood, protein, bilirubin, nitrates and
other abnormal constituents revealed by microscopic examination of the urine sediment.
A 10 mL urine specimen is usually sufficient for conducting a routine urine test.
Normal Values
Volume: 600 to 2500 mL in 24 hours
Color: Pale yellow to amber
Appearance: clear to slightly hazy
Specific gravity: 1.005 to 1.025 with a normal fluid intake
pH: 4.5 to 8
Glucose: negative
Ketones: negative
Blood: negative
Protein: negative
Bilirubin: negative
Nitrate for bacteria: negative
Casts: negative, occasional hyaline casts
Red blood cells: negative or rare
Crystals: negative or none
White blood cells: negative or rare
Epithelial cells: few; hyaline casts: 0-1/lpf
Nursing Considerations for Routine Urinalysis
1. Instruct the patient to void directly into a clean, dry container. Sterile, disposable
containers are recommended. Women should always have a clean-catch specimen if a
microscopic examination is ordered. Feces, discharges, vaginal secretions and menstrual
blood will contaminate the urine specimen.
2. Collect specimens form infants and young children into a disposable collection apparatus
consisting of a plastic bag with an adhesive backing around the opening that can be
fastened to the perineal area or around the penis to permit voiding directly to the bag.
Depending on hospital policy, the collected urine can be transferred to an appropriate
specimen container.
3. Cover all specimens tightly, label properly and send immediately to the laboratory.
4. If a urine sample is obtained from an indwelling catheter, it may be necessary to clamp
the catheter for about 15-30 minutes before obtaining the sample. Clean the specimen
port with antiseptic before aspirating the urine sample with a needle and a syringe.
5. Observe standard precautions when handling urine specimens.
6. If the specimen cannot be delivered to the laboratory or tested within an hour, it should
be refrigerated or have an appropriate preservative added.