The routine analysis of a urine specimen is a simple, noninvasive diagnostic test that provides a health-care provider with a window to a patient's health. Many significant conditions may be noted with the assessment of the physical, chemical, and microscopic examinations of a patient's specimen. This chapter reviews the function of the urinary system and the formation of urine. You will learn about various types of urine specimens and how to properly instruct or assist patients with the collection of these specimens. Additionally, you will learn how to correctly process a specimen, including a random specimen and a chain of custody drug screen. You will learn to identify normal and abnormal constituents of urine samples and what may cause these abnormal elements to be present in a specimen.

Outline

• The Role of the Medical Assistant
• Anatomy and Physiology of the Urinary System
• Obtaining Specimens
• Urinalysis

Learning Outcomes

After completing Chapter 47, you will be able to:

 47.1 Describe the characteristics of urine, including its formation, physical composition, and chemical properties.
 47.2 Explain how to instruct patients in specimen collection.
 47.3 Identify guidelines to follow when collecting urine specimens.
 47.4 Describe proper procedures for collecting various urine specimens.
 47.5 Explain the process of urinary catheterization.
 47.6 List special considerations that may require you to alter guidelines when collecting urine specimens.
 47.7 Explain how to maintain the chain of custody when processing urine specimens.
 47.8 Explain how to preserve and store urine specimens.
 47.9 Describe the process of urinalysis and its purpose.
 47.10 Identify the physical characteristics present in normal urine specimens.
 47.11 Identify the chemicals that may be found in urine specimens.
 47.12 Identify the elements categorized and counted as a result of microscopic examination of urine specimens.

Summary

The volume and physical, chemical, and microscopic characteristics of urine provide a great deal of information about a patient's health. Although invasive collection methods are sometimes necessary, routine urine specimens can be obtained by noninvasive, painless means. Urinalysis is the most common diagnostic test performed in doctors' offices.

You will have a substantial role in collecting, processing, and testing urine specimens. You will need to understand the urinary tract system and the basic characteristics of urine, including how it is formed, its physical composition, its chemical properties, and its microscopic characteristics.

Assisting patients and instructing them in the procedures required to collect different types of specimens are important aspects of your job. You must understand the purposes and procedures for collecting random specimens, first morning specimens, clean-catch midstream specimens, timed specimens, and 24-hour specimens. Throughout all collecting and processing procedures, you must practice quality assurance and employ precautions to avoid spreading disease-causing microorganisms.

When obtaining and processing specimens, you need to follow general guidelines as well as take into account special considerations for specific groups of patients. You are responsible for ensuring that specimens are preserved and stored so that they are not contaminated or otherwise altered.

You may perform some tests on urine and prepare urine specimens for evaluation by the doctor. In either case you must be able to distinguish between normal and abnormal findings concerning the physical, chemical, and microscopic characteristics of urine.

Urinalysis provides important information to the doctor. You play a significant role in seeing that the specimen has been properly collected, processed, and tested, so that the information obtained from the analysis is useful and accurate.