NUR117: Urine  Dipstick Test

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NUR117: Urine  Dipstick Test

NUR117: Urine  Dipstick Test

5. A nurse is performing a urine dipstick test on a child who has nephrotic syndrome. Which of the following results should the nurse expect?

Urine Dipstick Testing

Urine Dipstick Testing

Dipstick Analysis: The accuracy
of detecting microscopic hematuria,
significant proteinuria, or urinary
tract infection is a subject of much
interest and practicality to emergency physicians. The urine dipstick
has false-positive and false-negative
results, and a list is presented in the
table. It also should be noted that
the commonly used urine dipstick
has a finite lifespan, should be kept
in a closed container, and should
not be constantly exposed to air.
Testing with outdated and improperly stored materials can lead to erroneous results. Dipstick testing is
quite helpful, serving as a screening
test for some conditions and a
definitive test for others. Dipstick
testing in complicated cases or serious disease must be correlated with
microscopy and clinical parameters.

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Urine Specific Gravity: Urine
specific gravity (USG) generally
correlates with the urine osmolality.
The most useful information derived from the USG is insight into
the patient’s hydration status and
the concentrating ability of kidneys.
The latter function is disrupted in
a variety of diseases.
The normal USG ranges from
1.003 to 1.030. USG less than 1.010
is suggestive of relative hydration,
and values greater than 1.020 indicate relative dehydration. Pathologic conditions that increase the
USG without regard to hydration
included glycosuria and syndrome
of inappropriate antidiuretic
hormone secretion (SIADH).
Osmolality is the more important
parameter to measure in such
cases. A decreased USG, also
known as dilute urine, is associated
with diuretic use, diabetes insipidus, adrenal insufficiency, aldosteronism, or a plethora of conditions
causing impaired renal function.
It should be noted that the
purpose of the kidney is to concentrate urine when needed. Many
renal diseases alter this concentrating function and result in a fixed
specific gravity — about 1.010, the
specific gravity of the glomerular
filtrate. This is known as isosthenuria, a condition seen, for example,
in patients with renal dysfunction
because of sickle cell disease.

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