Slide

#1
Urine Collection by Prof Cesar Castillo Jr

#2
Kidney
-specific organs that produces urine

Ureter
-tube after kidney

Urinary Bladder
-for storage

Urethra
-after bladder

Main function of kidney

-to remove waste and remove extra fluid, normal it filters blood, 30Ml of urine per
hour, it releases hormones that regulate blood pressure which is Renin
--it also produce an active form of Vitamin D that promotes strong, healthy bones
-eryhtropoiten is a hormone that stimulates production and maintenance of RBC in
bone marrow

Renin
-enzyme that is produce by the kidney
-Renin is detected by baroreceptor
-Renin is release pag mababa ang bp that is detected by baroreceptor when there is
not enough sodium in your body
-helps kidneys retain water and sodium
-increase water thus increasing the bp

Vasoconstriction
Vasodilation
Aldosterone
-is release from Adrenocortex
Vitamin D
-to activate Melanin

Renin ANgiotension-aldosterone system

-it is a chain reaction designed to regulate your blood pressure

How does it works?

2. Ureter
-narrow tubes carry urine from the kidneys to the bladder
-emptying urine into the bladder about every 10 to 15 seconds

3. Urinary Bladder
-is a temporary storage reservoir for urine
-allowing urinstion to be infrequent and controlled
-normal capacity of the bladder is 400-600 mL

4. Urethra
-in females 1.5 to 2 inches long or 3.8 to 5.1 cm and sits between the clitoris and
the vagina (more prone to infection)
-in males it is about 8 inches or 20 cm long, runs the leghth of the pens. the male
urethra is used to eliminate urine as well as semen during ejaculation
5. Urine
-liquid by-product of metabolism in humans and in many other animals

Composition
-Water (H2O):95%
-it contains uric acid 1.4L or .6 grams of uric acid
-bicarbonates ions 1.?/grams
-Urea (H2CONH2): 9.3g - 23.3g/l
-Chloride (Cl-): 1.87g/l-8.4g/l
-Sodium (Na+): 1.17g/l - 4.39g/l
-Potassium (K+): 0.750g/l - 2.61g/l
-Creatinine (C4H7N30): 0.670 g/l - 2.15 g/l (it is the byproduct of metabolism of
our muscle, the wear and tear) 0.6 - 1.2 (pag nasa 4 and above, subject na for
dialysis)
-Inorganic Sulfur (S): 0.163 - 1.80g/l
-BUN 6 to 24 mm/dl

Chemical Elements in Human Urine

The Element abundance depends on diet, health, and hydration level, but human urine
consists of approximately

Oxygen: 8.35 g/l

Nitrogen: 8/12 g/l
Carbon: 6.87 g/l
Hydrogen: 1.51 g/l

Urea
-by product of food

Creatinine
-by product of muscle mass

Normal Color:
Amber Yellow ranges from pale yellow to deep amber

WHY: Fluids dilute the yellow pigments in urine, so the more you drink, the cleare
your urine looks

Kidney Dysfunction Indicator:

1. Creatinine
-it is a waste product that comes from the normal wear and tear on muscles of the
body
-if high, it indicates na hindi okay si Kidney

2. Blood Urea Nitrogen

-Urea nitrogen is a normal waste product that your body creates after you eat
-Liber > break down protein > by product of blood urea notrogen > kidney

3. Estimated/Measure Glomerular Filtration rate - measures how well your kidneys

filters blood

Glumerular filtration rate

-pag mas mabagal, bawas ang kidney function
-60 to 100 rate means nasa normal function
-2 types:Estimated GFR (widely available) and Measured GFR (mas mahal)
4. Albumin
-a protein found in blood
-a healthy kidney does not let albumin pass into the urine
-A damaged kidney lets some albumin pass into the urine.
-the less albumin in your urine, the better (ALbuminuria) baka nagkabutas, baka
nagkasira

5. Sugar
-glycosuria is a condition in which a person's urine contains more sugar, or
glucose, than it should. it typically occurs due to high blood sugar levels or
kidney damage

Urine Collection
-one of the easist specimen to collect
-reveals kidney function
-use to treat if any kidney problems
-unang urine,

First Voided Specimen

-sample also referred to as a first morning specimen.
-this sample is collected the first time the patient urinates in the morning.
-A first voided specimen is the most concentrated and is the preferred specimen for
pregnancy testing, bacterial cultues, and microscopic examinations
-common test for STIs like clamydia trichomatis (causes inflammation in urinary
tract)
-collect a sample of urine pagkagising and then ipass sa lab within 1 hr, it should
be midtsream, ask the pt to refrigirate pag wala sa hospital

TYPES OF URINE COLLECTION:

1. First morning/void/catch/pass specimen
-from time of waking up
-more concentrated
-abnormalities are easier to detect
-is also relatively free of dietary influences

2. Single random specimen

-anytime of the day
-usually used only for "routine screening because the composition of urine chnages
throughout the day

UTI:
-common in women because of shprter URETHRA and closer to RECTUM (1.5 to 2 inches)

Other factors that can increase the risk of UTIs

-a previous UTI
-sexual activity
-changes in the bacteria that live inside the vagina, or vaginal flora. For
example, menopause or the use of spermicides can cayse these bacterial changes
-pregnancy
-age (older adults and young children are more likely to get UTIs)
-structural problems in the urinary tract, such as enlarged prostate
-poor hygiene, for example, in children who are potty-training

if recurrent ang UTI, ipa culture and sensitivity para maprevent and pagdevelop ng
resistances

CAUSED BY:
Eschirechia Coli (gram-negative)

Bacteria:
Cell wall-structure and form

Gram Positive
-thin cell wall (monoderm)
-thicker peptidoglycan
-reatin stain (crystal violet)
-mas madali patayin ng antibiotics kasi mas thin ang wall

Gram-Negative
-thicker cell walls (diderms)
-difficult to kill and creates resistance
-sandwhich peptidoglycan
-can be more resistant
-more resistant to antibiotic because of thick

PROCEDURE
-a non-sterile collection container
-instruct to collect a mistream specimen in the container
-simple used for U/A and not for C/s
-ang random sample and hindi ginagamit for CS, ginagamit lang sya for random check

3. Timed Specimens/24 hr urine collection

-is a simple lab test that measires what's in the urine
-done by collecting your urine in special container over a full 24hr period
-must be kept cool until the urine is returned to the lab
-para madiagnosed and different type of kidney problems

INDICATION:
-helps diagnose kidney problems
-is often done to see how much creatinine clears through the kidneys
-also done to measure protein, hormones, minerals, and other chemical compounds

PROCEDURE
3.1 doctor's order, binibigyan ng collection bottle approximately 1 gallon, put
label (name, date, collection time and end)
(container has preservative requirements checked by the lab tech, with caution bec
its caustic (able tot burn or corrode organic tissue by chemical action)

3.2 the test usually begins in the morning. the first void in DISCARDED in the
toilet and record the time.

3.3 For the next void, start collecting record the time (same time will end the
next day)

*refrigirate the container during collection period

-close the lid tightly

-unang ihi ng unang araw, hindi na isasama kasi naipon nayon kinahapunan pa e duh
huhu
-sa ref ilalagay, lagyan ng label

4. Clean-cath midstream specimen:

-clean urine for culture and sensitivity testing, bacterial growth and cytology
-"mistream"- discarding the first and last voided stream
PROCEDURE:
4.1 Give the patient as sterile urine collection kit
4.2 Wash hands thoroughly with soap and water, rinse and dry
4.3 open the collection package but DO NOT TOUCH INSIDE OF CUP OR RIM

Male: Retract foreskin if present. Open the package of 3 towelettes with the first
towelette, cleanse the urinary opening of the penis starting at the center and work
outward. Repeat the cleansing in the same nmanner with the two remaining towelletes

4.4 begin to void urine, letting the first 20-25 mL pass into the toilet

4.5 Position
the cup in the stream of urine until the container is about hald to two-thirds
full. finish voiding into the toilet

4.6 After obtaining the urine specimen, screw the lid on tightly again being
careful to avoid touching the inside the container or lid

4.7
Bring the spcimen to the lab within 1 hr ot collection or store refrigirated for up
to 24 hrs

5. Dirty Collection test

-first part of voided stream is collected
-speciment will be used for DNA testing

6. Catheterized Specimen
-Straight catheter:
14FR to 16FR Men
10FR to 12FR women
-done by trained by trained professional
-wala ng connection sa urinary bag, pagpasok mo lalabas agad ang wiwi
-Indwelling catheter: nagpapasok tayo ng sterile catheter until mareach and urinary
bladder. pag may nakita kana urine, pasok mopa 1 inch and saka ka mag inject ng 10
cc water, done for pt na may surgery, kidney problems, paralysis downwards

*in collecting any urine speciment, it is always important for the nurse to observe
specific agency protocols, to check with the laboratory regarding the need for
refregeration or preservation of specimens, and to follow unversal precautions

*How should I collect and store a pee (urine) sample?

-label a sterile, screw-top container with your name, date of birth and of the
date, wash your hands
-start to pee and collect a sample of urine
-screw the lid of the container shut, wash your hands thoroughly

retdem-wisdom, knowledge, and understanding

Note:
we are going to research about the diff kidney problems and what are the common
caused of kidney problems and then the recommended medications/management and
nursing management and associated speciment urine collection to be submitted on f2f
3rd week hard copy

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TRANSDERMAL PATCH/TIDDS
(transdermal drig delivery system)
-it is a medcated adhesive patch that is placed on the skin to deliver a specific
dose of medication through the skin and into the bloodstream

LAYERS:
1. Backing film
-protects the drug formulation
-design, durability and resiliency

2. Drug formulation
-active ingredient (or multiple ingredients)

3. Membrane
-determines the rate of drug formulation that is delivered into the skin

4. Liner
-layer protects the skin-contacting adhesive and is removed right before the patch
is applied to the user

5. Adhesive or tape
-bottom layer the uses skin-friendly