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URINALYSIS URINARY SYSTEM Kidneys Ureters Bladder Urethra URINE COMPOSITION Water Nitrogenous Waste Mineral Salts Pigments STANDARD PROCEDURE Collection Container Storage Qualitative vs Quantitative URINE SPECIMEN COLLECTION Random or Spot Fasting First Morning Postprandial Specimen Midstream Clean-catch Timed (24 hour) PHYSICAL CHARACTERISTICS Appearance Color Odor Quantity Specific Gravity CHEMICAL Reaction (pH) Protein Glucose Ketone Bilirubin Blood Nitrite Urobilinogen Leukocytes Specific gravity MICROSCOPIC Red Blood Cells White Blood Cells Epithelial Cells Casts Bacteria Yeast and Parasites Spermatozoa Terminology Anuria Oliguria Polyuria Dysuria PURPOSE OF CATHETERS Drain, irrigate or instill meds Assist incontinent patients Help begin bladder retraining Keep bladder empty while surrounding tissues heal after surgery Diagnose disease, malfunction, or injury CATHETERS Indwelling (Foley) catheter Alcock catheter Double lumen with balloon to be filled with distilled water Third lumen for irrigation Straight Catheter Single lumen SIZES Female – 1.5-2 inches in length Male – 5.5-7 inches in length 14F-16F 16F-20F Smaller number, smaller lumen TRANSPORT Keep drainage bag below bladder Drainage tubing must be coiled and resting on patients legs or hooked on chair. If bag must be lifted, be sure to clamp tubing to bag, not catheter. ALTERNATIVE METHODS Suprapubic catheter Placed directly into bladder through abd Used to divert flow from urethra due to surgeries, obstructions, loss of bladder control, etc Condom catheter Externally applied and for those prone to urinary tract infections. Changed every 24-48 hours CYSTOGRAPHY Using fluoroscopy and radiography to visualize the bladder as it fills and empties. Cystourethrography –bladder and urethra Voiding cystography – pt’s ability to empty bladder Voiding Cystourethrography – urethra studied as pt voids upon removal of catheter RETROGRADE PYLOGRAPHY To visualize proximal ureters and kidneys after injection of contrast. Performed in cystoscopy suite with urologist Assesses ureters for obstruction Stents may be placed due to stricture, edema or tumors