Question

Emma, a medical laboratory technician is reviewing the following urinalysis report before she releases it to the physician.

Routine Urinalysis

COLOR	Yellow
CLARITY:	Slightly Cloudy
SP. GRAVITY:	1.015
PH:	7.0
BILIRUBIN:	Negative
KETONES:	Negative
BLOOD:	Negative
PROTEIN:	Negative
UROBILINOGEN	0.2 EU
NITRITE:	Negative
GLUCOSE:	Negative
LEUKOCYTE	Negative

Microscopic
0-1 WBC/HPF
25-30 RBC/HPF
Rare squamous epithelial cell
Negative for bacteria and casts

In your discussion post, discuss the correlation between the chemical and microscopic exam. Some items to include in your discussion, but not to be limited by are:

What is the tech's first course of action to investigate the results?

What other actions should be includes?

What are five possible explanations for the results?

How would you rule out each of the possible explanations?

Answer 1

URINALYSIS: is an analysis of the urine.

CORRELATION BETWEEN CHEMICAL AND MICROSCOPIC EXAMINATION: is usually performed by using test strips with rows of test pads called reagent in the laboratory. Each pad on the urine contains different rows with different chemicals to indicate the presence of specific substances in the urine. The reading is automated to prevent errors of interpretation and timing. It helps to detect or ensure correct results. In chemical examination, the following readings can be checked: a) protein b) blood c) pH level d) nitrates e)bilirubin f) urobilinogen g) ketones h) glucose and i) specific gravity.

MICROSCOPIC EXAMINATION: this examination helps to look at cells in the urine sample. This is done to perform additional information or to find out the diagnosis of a disease. It gives accurate information and is performed if the physical or chemical exmination shows any abnormal findings. Red blood cells, white blood cells, epithelial cells, casts, crystals and microorganisms like yeast, trichomonas and bacteria are done under microscopic examination.

The first course of action of a medical laboratory technician is to repeat the urinalysis again with the sample provided and check for any errors or abnormal findings. The other possible actions are: a) hand hygiene and wearing of gloves before performing the examination b) inform the physician if there is any abnormal findings c) check the condition of patient with nurse to confirm the results and d) counter checking the reults to avoid any errors.

The five possible explanations for the results is: a) the low pH shows alkaline reaction which increases as time passes. A low pH indicates, the presence of kidney or bladder stones in the patient b) The test of nitrite can be an indicator of the presence of a broad spectrum of certain bacteria that leads to urinary tract inection. c) Urobilinogen: a negative test for bilirubin but positive for urobilinogen indicate haemolytic diseases d) The yellow color in the urine indicates the presence of excessive riboflavin ( vitamin B2) intake and e) RBCs indicates the presence of glomerulonephritis.

Most of the urinary infections and diseases can be ruled out by increasing the intake of fluid daily.