PRACTICUM I MACROSCOPIC EXAMINATION OF URINE 1.1 Urine Color Title : Urine Macroscopic Examination Objective : As a filter reaction to see abnormalities in urine through macroscopic vision. Newly excreted normal urine appears clear to slightly cloudy and yellow in color with the pigments urochrome and urobilin. The color intensity corresponds to the urine concentration; dilute urine is almost colorless, concentrated urine is dark yellow or brown. Abnormalities in color, clarity and turbidity can indicate possible infection, dehydration, blood in the urine (hematuria), liver disease, muscle or erythrocyte damage in the body. Certain medications can change the color of urine. Purpose: to determine the color of urine Method: visual Principle: urine color is tested at a thickness of 7 – 10 cm, with bright and background light white back at an angle Tools & Materials: - Beaker glass - Test tube - Urine sample - White background Procedure: 1. Put ¾ of the tube full of urine into the test tube 2. Tilt the test tube until it forms a 60º angle 3. Urine color is tested at a thickness of 7 – 10 cm with bright light and a white background Normal values: light yellow – dark yellow 1.2 Urine Clarity New and normal urine is generally clear. Turbidity usually occurs due to crystallization or deposition of urates (in acidic urine) or phosphates (in alkaline urine). Turbidity can also be caused by excessive cellular material or protein in the urine. Purpose: to determine urine clarity Method: visual Principle: urine clarity is tested in the entire tube with reflected light without a background white back at an angle Tools & Materials: - Beaker glass - Urine sample - Test tube Procedure: 1. Put 3/4 of the tube full of urine into the test tube 2. Tilt the test tube until it forms 60º 3. Urine clarity can be tested on the entire tube with reflected light without a white background at an angle Normal value: Clear 1.3 Specific Gravity of Urine Measurement of urine specific gravity aims to determine the concentration or dilution function of the kidneys and the composition and dilution of urine. Measurement of urine specific gravity also serves to differentiate oliguria due to dehydration. Purpose: to determine the specific gravity of urine and check the concentrating function of the kidney Principle: Bj urine is checked with a urinometer that has been checked using correction factor. Tools & Materials: - Beaker glass - Measuring cup - Urine sample - Urinometer - Thermometer Procedure: 1. The urinometer is calibrated with distilled water 2. Put the urine into the measuring cup until it is ¾ full. 3. Check the urine temperature using a thermometer 4. Insert the urinometer, then remove it while rotating it so that it floats freely and does not stick to the walls of the measuring cup 5. Read the results on the urinometer stem at the level of the lower miniscus Correction factor Specific gravity examination using a urinometer requires a correction factor. These correction factors include: 1. Calibration factor with distilled water - example Bj distilled water = 1.004 - Bj urine so reduced by 0.004 - example Bj distilled water = 1.006 - Bj urine so reduced by 0.006 2. Temperature factor - First read the temperature on the urinometer - then determine the temperature of the measurement room - every 3 degrees Celsius increase in urinometer temperature - Bj urine + 0.001 3. Dilution factor - Amount of dilution of urine x 2 last numbers in Bj urine - Example: dilution 2 x Bj urine 1.011 - 2 x 11 - Bj urine 1.022 Method: Refractometer Principle: light entering through a light prism can only pass through the boundary plane between the fluid and the working prism with an angle that lies within certain limits determined by the boundary angle between the fluid and the base. Work procedures: - Prepare the refractometer and calibrate with distilled water - Place a drop of urine on the surface of the refractometer prism - The prism surface of the refractometer is closed and allows the light beam to enter, passing through the liquid compound and the prism regulator - Set the lighting, then look directly 1.4 Urine PH Method: Universal indicator Objective: to determine the ability of the kidneys to maintain hydrogen concentration Principle: The pH of urine is checked with universal paper dipped in urine, and color that is formed is equated with the color of the universal pH standard. Tools & Materials: - Beaker glass - Tweezers - pH strips - urine sample Procedure: 1. Place the urine sample in a beaker glass 2. Take the pH strip with tweezers 3. Dip it in the urine sample for 30 seconds, then drain it 4. Compared the color change with the standard pH strip color Normal Value: random urine 4.6 – 8 urine 24 hours ± 6.2 1.5 Urine volume In adults, normal urine production is around 1.5 L in 24 hours. This amount varies depending on: body surface area, fluid consumption, and air humidity/ evaporation. Abnormal Urine Volume Polyurea:increased urine volume, found in conditions such as: Diabetes, Chronic nephritis, some neurological diseases, resolving edema. Oliguria: Reduced urine volume can occur in conditions such as disease kidney disease, dehydration and liver cirrhosis. Anuria:no urine production, can occur in conditions such as circulatory collapse(systolic < 70 mmHg),acute renal failure, sublimate poisoning, etc. Residual urine: the volume of urine obtained from previous catheterization The patient is told to urinate as much as he can.