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Urinalysis 3.4.5

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Abby Schwaiger

on 8 March 2015

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Transcript of Urinalysis 3.4.5

Urinalysis
Abby Schwaiger, Jennifer Braun, Jessica Brames & Anne Lonsway
Patient 2
Patient 3
Patient 4
Based on what you know about the function of the nephron, why should urine be free of blood cells?
Urinalysis is an important diagnostic tool for the determination of medical disorders. However, urinalysis has many other uses. Describe one other reason a person may have his/her urine tested.
Patient 6
Explain why diagnostic tests are classified as a type of medical intervention.
Proteinuria
Female - 60 Years old
Diagnosis:
Renal Failure
The nephron's job is to filter waste products out of the blood and to allow reabsorption o f nutrients into the blood. If blood is found in urine, that means that there is a problem in the filtration being done by a person's nephrons. The nephrons are filtering the red blood cells out of the person's blood and putting them in urine, taking that blood away from the body. The nephrons should only be filtering out waste [roducts from the blood, not the blood itself from the body.
Urinalysis can be used to determine if there are drugs circulating throughout the body. Some workplaces require regular urine testing (drug tests) in order to be sure that an employee has not been taking any illegal drugs. Testing a person's urine can also show whether or not they are pregnant.
Diagnostic tests are classified as a type of medical intervention because they are examinations, treatments or any kind of preventative course of action for a patient so that a physician may intervene with the problem using the correct treatment in order to help a person get better.
Period 1
What Results Led to Your Diagnosis?
What is the Relationship Between the Urine and the Disease/Disorder?
An increase in ketones were found (40-80 mg/dl)
Anorexia is a mental disorder that results in an increase of ketones because of a loss of ATP. The body begins to digest the excess fat, this causes Ketoacidosis. There is an increase in broken down fat cells (ketones) in the urine.
Persistent urge to urinate
Burning sensation during urination
Lower back pain
Low-grade fever
Color
Bright green-yellow
Clarity
Foggy
pH
9.0
Specific Gravity
1.000
Protein
15 mg/dL
Glucose, Ketones & Erythrocytes
Not present
Leukocytes
Present
Other Abnormalities
Some crystals
Symptoms
Urinary Tract Infection
How did the Urinalysis results lead to the diagnosis?
The only abnormal
factor found in the urinalysis was an elevated amount of protein. This lead to the belief that Patient #2 had proteinuria. Proteinuria is a condition where high levels of protein are found in the urine. Patient #2 also partook in strenuous exercise, which could be the reason for protein in his urine. Otherwise, he's relatively healthy.
How did the results lead to your diagnosis? What is the relationship between what you see in the urine and the disease?
Of the Patient
General
The urinalysis results lead me to the diagnosis of renal failure when it showed indications of high protein, high specific gravity, and the presence of red blood cells in the urine.
The high protein in the urine indicates proteinuria, which is an indication of kidney damage, or chronic kidney disease, and also shows that the kidneys have stopped filtering the blood correctly.
The high specific gravity of the urine indicates that the patient is also dehydrated, which can occur due to damage to the kidneys, and can also contribute to the coloring of the urine.
The presence of red blood cells in the urine (or hematuria) depending on the amount can be a sign of major problems in the urinary tract, which is apparent in this patient due to the orange coloring of the urine.
Symptoms
Patient's Symptoms
Protein - 15 mg/dl
Symptoms
How did the urinalysis results lead you to your diagnosis? What is the relationship between what you see in the urine and the disease or disorder?
Pain or burning during urination
Persistent urge to urinate
Difficulty urinating
Foggy urine
Lower back pain
Fever
Chills
Nausea and vomiting
Weight loss
Little energy
Hair loss
No menstruation for 3 months
Increase in ketones in urine (40-80 mg/dl)
How does the disease relate directly or indirectly to other body systems?
What further tests should be done to confirm this diagnosis?
Symptoms of the disease:
Possible Treatments
How does this disorder relate directly or indirectly to other human body systems?
What further tests should be done to confirm your diagnosis?
How does the disorder relate directly or indirectly to other human body systems?
What are possible treatments for your patient?
Antibiotics will be prescribed and taken as directed. The patient should drink a lot of water and empty her bladder every time she urinates.
Further tests to confirm the diagnosis of the patient:
Possible treatments:
Proteinuria Symptoms
High levels of protein in urine
Frothy urine
Swelling in abdomen, face, feet, and hands
Chest pain
Difficulty breathing
Difficulty urinating
Anorexia:
Psychotherapy- addresses the underlying emotional and cognitive issues that result in the disorder
Antidepressants- can treat any depression that comes along with the disorder
Cognitive-Behavioral Therapy- helps a patient understand how negative self-talk and self-image can impact their eating and behaviors
Ketoacidosis:
Hospitalization is recommended, the patient should be slowly rehydrated and fed. Glucose should also be given in order to increase energy.
In a serious situation, UTIs can lead to sepsis, a blood infection, affecting to cardiovascular system. This infection can be fatal if left untreated.
Grow a culture of urinary tract bacteria
Get images of the urinary tract
Ultrasound
CT scan
Intravenous pyelogram
Use a scope to view the inside of the bladder
By looking at the results of the tests conducted, the main clue to the fact that patient #3 has a urinary tract infection (UTI) is the color and clarity of the urine. Since the urine was green-ish, it was a good clue to that diagnosis. The fogginesss was another good indication of a UTI. The other symptoms of the patient were good give aways as well. Minor fever, lower back pain and pain during urination are major indicators of a UTI.
How does this disorder relate directly or
indirectly to other human body systems?
Proteinuria can cause a deficiency of protein in the human body. If there is a significant protein loss, it can affect the muscular system and can cause damage to the muscles, hair, bones, and nails. People with diseases such as diabetes should get tested regularly in order to prevent kidney damage, possibly causing proteinuria.
What further tests should be done to confirm your diagnosis?
Tests measuring the amount of creatinine in the blood will show whether or not a person's kidneys are removing wastes properly. Too much creatinine can be a sign of kidney damage.
What are possible treatments for your patient?
Since proteinuria is not a specific disease, treatments depend on identifying an underlying cause. If someone has diabetes or hypertension, they should regularly check their glucose levels and stick to a healthy diet. If a patient has high blood pressure, a doctor can prescribe a drug that will protect the kidney function such as an ACE (angiotensin-converting enzyme) inhibitor.
Male - 18 years old
The patient has presented with symptoms of:
Unusual fatigue
Occasional dizziness
Problems sleeping at night
Swelling in the feet and the ankles
Puffiness in the face
Frequent burning pain in the lower back, just below the rib cage
Elevated blood pressure
Red blood cells present in the urine
Clear/Orange Urine Coloring
High Specific Gravity: (1.030)
High Protein Content in Urine (15mg/dl)
Renal Failure directly relates to the Urinary/Excretory System:
Since there is a persistent infection of the kidney when renal failure is occuring, this can lead to other diseases of the kidney, as well as obstructions to the bladder. This can also affect urine output, as well as the homeostasis of water and electrolytes in the blood
Renal Failure Indirectly relates to the Cardiovascular System:
The dysfunction of the kidney can cause high blood pressure.
The Anemia caused by renal failure, can put a strain on the heart due to insufficient red blood cells.
Uremia (high levels of urine in the blood) or waste build up in the blood can also occur, this can lead to inflammation in the pericardium, and sac around the heart.
The Uremia can also result in failure of other organs as well as problems in the central nervous system.
Electrolyte iimbalances that can occur due to renal failure can affect the muscles, causing fatigue and an irregular heart beat.
Skeletal System- if no enough calcium is given to the bones, the bones, in result, become weaker
Circulatory System- as the body loses muscle mass, the heart decreases in size, by result the circulatory system is not as efficient
Reproductive System- a loss of menstruation can possibly result in infertility
EKGs (Electrocardiograms)
Complete Blood Count Test
Bone Density Tests
Tests for Electrolyte Imbalances
Test for Protein Deficiencies
Anorexia and Ketoacidosis
There are multiple types of lab tests (blood&urine) that can be used to help confirm the diagnosis and progression of renal failure:
Serum Creatinine :
- this can show the increase of creatinine in the blood, which is usually the first sign of acute renal failure
BUN (Blood Urea Nitrogen):
- Measures the amount of nitrogen in the blood that comes from the waste product of urea.
Blood electrolyte tests to determine concentrations in the blood
CBC (Complete Blood Count): Provides important info on RBCs, WBCs and platelets, to look for diseases that could cause renal failure
ESR (Erythrocyte sedimentation rate) ANA (Antinuclear Antibodies) Urinalysis, testing for Urine Eosinophils, 24-hour Urine Collection.
Some Imaging tests: (Some depend on suspicion of blockages)
Abdominal Ultrasound
CT Scan (Computed Tomography)
Abdominal X-ray or Spiral CT
Retrograde Pyelography
MRI (Magnetic Resonance Imaging)
Kidney Scan (Renal Scinitigraphy)
Depending on the cause of the renal failure, treatment can vary from:
Medication to relieve symptoms: (anemia, blood pressure, cholesterol, swelling)
Medication to protect the bones
Lower protein diets to minimize waste in blood
Dyalisis: (Hemodyalisis, Peritoneal Dyalisis)
Kidney Transplantation
Female - 23-years-old
Full transcript