Module 6 NCM 104a - Urine Testing

NCM 104a: COMMUNITY HEALTH NURSING (RLE)
TOPIC: Urine Testing
ACTIVATE PRIOR KNOWLDEGE:

➢
Identify the different solutions inside the PHN Bag and briefly explain the purpose
of each solution.
ACQUIRE NEW KNOWLEDGE

Urine Analysis
➢
It is the analysis of urine in order to find out the presence of sugar, albumin,
microorganisms or any other contents present in the urine.
➢
It is one of the oldest laboratory procedures in practice of medicine.
Purpose:
1. For general evaluation of health
2. For diagnosis of disease or disorders of the kidneys or urinary tract
3. For diagnosis of other systemic disease that affects kidney function
4. To monitor patients with diabetes
5. For screening drug abuse
Phases of Urine Analysis

1. Physical Examination
➢
which evaluates the urine's color and clarity.
Physical Examination: Normal Findings

Color Pale Yellow or Amber
Turbidity Clear
pH 4.5-8
Odor Aromatic
2. Microscopic Examination
➢
It is typically performed when there is an abnormal finding on the visual or
chemical examination, or if a healthcare practitioner specifically orders it.
➢
It identifies and counts the type of cells, casts, crystals, and other
components such as bacteria and mucus that can be present in urine
3. Chemical Examination
➢
Most clinical laboratories use commercially prepared test strips with test pads
that have chemicals impregnated into them.
URINE TESTING: GLUCOSE
Benedict’s Test
➢
It is used to test for simple carbohydrates and can be used to test for the
presence of glucose in urine.
➢
The test is based on Benedict’s reagent (also known as Benedict’s solution),
which is a complex mixture of sodium citrate, sodium carbonate and the
pentahydrate of copper (II) sulfate.
Procedure in performing the Benedict’s Test:
1. Prepare and assemble equipment.
2. Briefly and correctly states the name and purpose of the procedure.
3. Pour 5 mL of Benedict’s solution in the test tube.
4. Add 5 drops of urine in the test tube.
5. Heat the test tube and observes changes in color.
6. Cool the test tube on the test tube rack.
7. Provide correct interpretation of result.
8. Perform complete aftercare.
Interpretation of Benedict’s Test
Appearance of the Solution Concentration Interpretation

of reducing
sugar (G%)
Brick red with heavy precipitate 2% or >2% A large amount of reducing
sugar is present
Brownish orange with red precipitate 1.5% A moderate amount of
reducing sugar is present
Yellow with precipitate 1% A small amount of reducing
sugar is present
Greenish blue and cloudy 0.5% Traceable amount of
Greenish blue with yellow precipitate 0.25% Traceable amount of
Blue color or cloudy No reducing sugar is
present
GLYCUSORIA – presence of reducing sugars in the urine

Causes:
1. Diabetes mellitus: Type 2 DM and Gestational DM
2. Renal Diseases
Manifestations (if left untreated):

1. Extreme thirst or dehydration
2. Extreme hunger
3. Polyuria
4. Urinary incontinence
URINE TESTING: PROTEIN
Heat Coagulation Test

➢
A test for measurement of protein in urine; albumin and globulin coagulated
by heat at an acidic pH, and the amount of turbidity present provides a
qualitative estimation of the degree of proteinuria.
➢
Denaturation: When a protein is heated, its physical, chemical and biological
properties are changed due to breaking up of certain bonds. The conformation
of protein will be changed.
➢
Acetic acid present in the reagents breaks down peptide bonds on heating.
➢
If heat coagulable proteins – albumin and globulin are present, a dense
coagulum will be formed in the upper part of the solution. It may be compared
with the lower part of the solution which serves as control.
Procedure in performing the Heat Coagulation Test:

1. Prepare and assemble equipment.
2. Briefly and correctly state the name and purpose of the procedure.
3. Fill the test tube with 5 mL urine.
4. Heat the test tube until the urine boils.
5. Add 5 drops of Acetic acid (drop by drop).
6. Provide a correct interpretation
Amount of Coagulation Observation Amount of Protein

Negative No Cloudiness No protein
Trace Just Visible Clouds 0.5 g/dL
(+) Light Clouds no Coagulation 1 g/dL
(++) Have Clouds 3 g/dL
(+++) Light Coagulum 5 g/dL
(++++) Heavy Coagulum 10 g/dL
PROTEINURIA – increased levels of protein in the urine.

Causes:
1. Dehydration
2. Renal conditions
3. Intense exercise or activity
4. Emotional stress
5. Cardiovascular disease
6. Pre-eclampsia
7. Cardiovascular conditions
Manifestations (if left untreated):
1. Polyuria
2. Shortness of breath and tiredness
3. Nausea and vomiting
4. Swelling in the face and ankles
5. Loss of appetite
6. Muscle cramping
7. Foamy or bubbly urine
Types of Urine Samples
Sample How to collect the Purpose

sample
1. Random sampling No specific time Routine screening
Most common
Taken anytime of the day
2. Morning sample First urine in the morning Pregnancy test
Most concentrated Microscopic test
3. Midstream urine Collecting the middle Culture and sensitivity test
portion of the urine
4. 24-hour urine collection All the urine within 24 For quantitative and
hours must be collected qualitative analysis of the
urine
5. Urine Bag collection Collecting urine from the Microscopic test
catheter port Culture and sensitivity
6. Postprandial Taken 2 hours after meal Diabetic monitoring
7. Supra-pubic aspirated Needle aspiration Obtaining sterile urine
Assessment
1. Post Test
2. Return Demonstration
References:
1. Books
Aryal, S., & Iqbal, S. (2020, April 21). Benedict's Test- Objectives, Principle,
Procedure, Results. https://microbenotes.com/benedicts-test/.
Aryal, S., Prajjwal, Love, B., Hambe, Barnabas, A. (2019, August 15). Benedict's
Test- Principle, Preparation, Procedure and Result Interpretation. Microbiology
Info.com. https://microbiologyinfo.com/benedicts-test-principle-composition-
preparation-procedure-and-result-interpretation/.
Prepared by:
NCM 104a/CHN (Skills) Lecturers

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NCM 104a: COMMUNITY HEALTH NURSING (RLE)

TOPIC: Urine Testing

ACTIVATE PRIOR KNOWLDEGE:

ACQUIRE NEW KNOWLEDGE

Phases of Urine Analysis

Physical Examination: Normal Findings

URINE TESTING: GLUCOSE

Interpretation of Benedict’s Test

Appearance of the Solution Concentration Interpretation

GLYCUSORIA – presence of reducing sugars in the urine

Manifestations (if left untreated):

Heat Coagulation Test

Procedure in performing the Heat Coagulation Test:

Amount of Coagulation Observation Amount of Protein

PROTEINURIA – increased levels of protein in the urine.

Types of Urine Samples

Sample How to collect the Purpose

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