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

3. Sterile Specimen
Indwelling catheter
Drainage bag

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

Specific Gravity
Concentration
1.010-1.025

Urine glucose

Diabetics
Reagent strips
Double void

TEST

NORMAL VALUES

Color

Pale yellow to amber

Turbidity

Clear to slightly hazy

Specific Gravity

1.015-1.025

pH

4.5-8.0

Glucose

Negative

Ketones

Negative

Blood

Negative

Protein

Negative

Bilirubin

Negative

Urobilinogen

0.1-1.0

Nitrate for Bacteria

Negative

Leukocyte Esterase

Negative

Casts

Occasional hyaline casts

Red Blood Cells

Negative or rare

Crytals

Acid Urine:
Amorphous urates
Uric acid

TEST

Normal Value of Urine

NORMAL Studies
EXPLANATION
NURSING
RESULT

RESPONSIBILITIES

Urinalisis

Warna, bau, Biochemicak &

BJ, pH,
mikroskopis
Protein,
Glukosa,
Keton, RBC,
WBC, Bakteri

Midstream clean
cacth tecnique.
Memberikan KIE yang
jelas tentang cara
pengambilan urin.
Menggunkan teknik
steril pada klien
dengan indwelling
kateter

Kultur &
sesitivity

No bacteria

Midstream clean
cacth tecnique.
Memberikan KIE yang
jelas tentang cara
pengambilan urin.
Menggunkan teknik
steril pada klien
dengan indwelling
kateter

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

Cont
TEST

NORMAL
RESULT

EXPLANATION

NURSING
RESPONSIBILITY

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

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

Urin 24 Jam
Electrolyte
Sodium
Chloride
Potasium
Calcium
Magnesium

Protein
Creatinine

40-220
mEq/Hr
110-259
mEq/Hr
25125mEq/Hr
100300mg/24 Hr
7,3-12,2
mg/dL
Rest: 50-80
mg/dL
Amb : <150

Identifikasi
penyakit ginjal

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
BUN
Serum Creatinine

Cr Clearance

Serum albumin

Normal Value
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
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