Examination of urine in fundamental of nursing include normal characteristics of urine and collecting 24 hrs urine and collecting midstream urine, test for acetone and test for specific gravity test for sugar, and test for bile salts and pigments etc

1. MS. PINKI

2. Method Of Collecting Midstream Urine
 Ask the client to clean the genital area with soap and water,
then rinse with water alone. In female clients, the labia are
separated for cleaning and kept apart until the urine had been
collected. In male clients, the foreskin should be retracted and
the glans penis is cleaned before the collected of the urine.
 The client begins to void into the toilet, commode or bed pan.
Then the client stop the stream of urine, the sterile container.
When enough urine has been voided, for specimen, the client
stops the stream again, the container is removed and then
finishes voiding in the original receptacle.

3. Cont…
 By this method, the first stream of urine flushes out the
organisms and mucus usually present at out the organisms and
mucus usually present at the meatus, so that accurate result can
be obtained.

4. Method Of Collecting 24 Hrs Urine Specimen
 24 hrs urine specimen means to collect all the urine
voided in 24 hrs. the collection of urine begins at 6 A.M.
ask the client to void at 6 A.M and discard the whole
urine. All subsequent voiding should be measured and
collected in the bottle which is labelled. Continue to
collect till next morning. Ask the client to void at 6 A.M.
on the next day and add it to the urine previously
collected.
 It is necessary to add preservatives to the urine to prevent
decomposition and multiplication of bacteria. A variety of
preservatives are available such as chloroform, boric acid,
formalin etc.

5. Examination of the urine
Characteristics of normal urine
Volume – an amount of 1000 to 2000ml of urine is
excreted in 24 hrs. the urine output depends upon the
water intake.
Color – the normal urine is pale yellowish or amber in
color.
Odour- the normal urine has an aromatic odour. When the
urine is collected and kept for sometime, strong ammonia
smell comes due to the decomposition of the urea.
Reaction – reaction of the normal urine is slightly acidic.

6.  Urine pH- 4.6-8.0 (slightly acidic) average pH below 7.
 Test For Specific Gravity- Urine specific gravity measures the
concentration of urine solute. urine specific is determined by
comparing the weight of a urine specimen with that of an
equivalent volume of distilled water which is 1.000. because
urine contains dissolved salts and other substance, it is heavier
than distilled water. Urine specific gravity normal ranges from
1.010-1.025.
 Specific gravity is usually measured using a urinometer (a
specially calibrated hydrometer designed to float in a cylinder
of urine). The more concentrated the urine. The higher the
urinometer floats and higher the specific gravity.

7.  Specific gravity also may be measured using a refractometer
which measures the refraction of light as it passes through a
urine specimen.
 The best result of urine specific gravity will be obtained with a
controlled specimen collected after fluid are withheld for 12-24
hrs. but usually a random specimen of urine is used.

9. Test For Albumin
 Hot test- Fill three- fourth of a test tube with filtered urine
(filtering removing pus if present). See that the reaction of the
urine is acidic. If found alkaline, add one drop of acetic acid
and make it acidic, heat the upper third of urine over the spirit
lamp and allow it to boil. Keep the mouth of the test tube away
from your face to prevent scalding. A cloud may appear either
due to phosphate or albumin. Add acetic acid drop by drop into
the test tube. If the urine still remains cloudy, it indicates the
presence of albumin. If it becomes clear, it indicates the
presence of phosphates. Discard the urine and clean the test
tube. No albumin is present in the normal urine.

10.  Cold test- pour a small quantity of nitric acid or sulphosalic
acid 3% into a clean test tube. Allow equal quantity of urine to
trickle down the sides of the test tube. If albumin is present, a
white precipitate will be seen where two fluids meet. Discard
the urine and clean the test tube.

11. Test For Sugar
 Benedict’s test- Take 5ml of benedict solution in a test tube.
Boil it over the spirit lamp, holding the test tube away from
your face. If there is no color change in the benedict’s solution,
add 8 drop of urine with a pipette into the test tube and shake
well. Boil again. Remove the test tube and allow it to cool. The
result may be recorded according to the color as blue, green,
yellow, orange and red.
Blue liquid with no deposit Absence of sugar
Green liquid without deposit Approximately 1% sugar
Green liquid with yellow deposit Approximately 2% sugar
Colourless liquid with orange
deposit
Approximately 3% sugar
Brick red 5% or above

12. Test For Acetone
 Rothera’s test- take 2 cm depth of ammonium sulphate
crystals in a small test tube and add equal volume of urine and
one crystal of sodium nitroprusside. Close the test tube with a
cork and shake the test tube. Take liquor ammonia and add it to
the urine, trickling through the sides. Read the result
immediately. If acetone is present, a permanganate purple
colored ring is formed at the junction of urine and ammonia.
 Test for bile salts- Hey’s test
 Test for bile pigments- Smith’s test