Chemical Screening of Urine by Reagent Strip
Continuing Education Credits
This course discusses the chemical tests that are an integral part of a urinalysis. Proper specimen handling and technique are discussed for key tests, including pH, specific gravity, protein, glucose, ketones, bilirubin, blood, nitrites, urobilinogen, and leukocyte esterase.
Objectives
- Define the optimal storage time and temperature for urinalysis samples.
- Review the proper storage of and procedure for the use of urinalysis reagent strips.
- Describe the chemical reactions, quality control measures, and interpretation of results for urinalysis reagent strip analytes including pH, specific gravity, protein, glucose, ketones, bilirubin, blood, nitrites, urobilinogen, leukocyte esterase.
- Explain the proper techniques used during urinalysis reagent strip testing; ensuring accuracy.
- Identify conditions and/or substances that may interfere with urinalysis reagent strip testing.
- Identify the additional testing protocols used to confirm urinalysis reagent strip testing results.
- Summarize the analytical principles of measurement in urinalysis reagent strip instruments.
Course Outline
- Introduction to Urine Chemical Reagent Strips
- Chemical Urinalysis Reagent Strips
- Urine Specimen Collection
- Urine Specimen Transport
- Reagent Strip Procedure: Manual or Semi-Automated Methods
- Handling and Storage of Urine Reagent Strips
- Which of the following statements is true regarding the storage and handling of urine reagent strips?
- All the following statements about the urine specimen are true except:
- Which of the following statements is true for the reagent strip procedure?
- True or False: Quality control procedures should be performed with each new lot of chemical reagent strips and as often as required by the laboratory's procedure.
- Urine pH Analysis
- pH Analysis: The Urine Specimen
- pH Reaction
- Urine pH: Acidic and Alkaline
- A urine specimen was collected at 6:00 AM and remained at room temperature until it was received in the laboratory at 3:30 PM. How may the pH of the specimen be affected by the extended time at room temperature if bacteria are present in the specimen?
- Match the following factors with the expected urine pH type.
- Urine Specific Gravity Analysis
- Measuring Specific Gravity (SG)
- Advantages and Limitations of the Chemical Reagent Strip Method for Specific Gravity (SG)
- Clinical Significance of Specific Gravity
- How does ion concentration in the urine relate to specific gravity?
- Urine Protein Analysis
- Protein Error of Indicators
- Confirmatory Testing for Urine Protein
- Clinical Significance of Urine Protein
- Clinical Significance of Urine Protein, continued
- Follow-up Testing for Positive Urine Protein
- The presence of increased levels of protein in the urine may be an early indicator of:
- Which of the following conditions is associated with benign proteinuria?
- Urine Glucose Analysis
- Glucose Reaction
- False-Positive and False-Negative Urine Glucose Results
- Clinical Significance of Glucose in the Urine
- All of the following conditions are associated with glycosuria (glucose in the urine) except:
- Urine Ketone Analysis
- Ketones Overview
- Ketone Reaction
- False-Positive and False-Negative Ketone Test Results
- Clinical Significance of Urine Ketones
- The ketone component that is measured by the nitroprusside reaction is:
- Which of the following can cause a false positive result for ketones?
- Significantly increased levels of ketones are detected in urine in all of the following conditions except:
- Urine Blood Analysis
- Introduction to Hematuria
- Blood Reaction
- False-Positive and False-Negative Blood Results
- Clinical Significance of Blood in Urine
- A urine sample appears cloudy and pink. The microscopic examination reveals the presence of intact red blood cells. What is the term that is used to describe this condition?
- Which of the following substances can cause a false positive result for blood on the urine reagent strip?
- Urine Nitrite Analysis
- Nitrite
- Nitrite Reaction
- Nitrite Test Sensitivity
- False-Positive and False-Negative Results
- Clinical Significance of Nitrite in Urine
- Nitrate in urine is reduced to nitrite by:
- Urine Leukocyte Esterase
- Leukocyte Esterase Reaction
- Leukocyte Esterase Reaction, continued
- False-Positive and False-Negative Results
- Clinical Significance of Leukocyte Esterase in Urine
- When screening for a urinary tract infection, which of the following reagent strip tests should the leukocyte esterase test be correlated with?
- Urine Bilirubin Analysis
- Overview of Bilirubin
- Bilirubin Reaction
- False-Positive and False-Negative Urine Bilirubin Results
- Ruling out False-Positive Urine Bilirubin Test Results
- Clinical Significance of Urine Bilirubin
- Which of the following may cause a false-positive bilirubin result on a urine chemical reagent strip?
- When a patient has a bile duct obstruction, the bilirubin test portion of the reagent strip is:
- Which form of bilirubin is indicated by a positive urine reagent strip test?
- Urine Urobilinogen Analysis
- Introduction to Urobilinogen
- Urobilinogen Reaction
- False-Positive and False-Negative Urobilinogen Results
- Clinical Significance of Urobilinogen in Urine
- True or False: Urobilinogen production is low or absent in biliary obstruction, which will be detected on the urine dipstick.
- Automation of Chemical Reagent Strip Analysis
- Semi-Automated Instruments
- Automated Systems
- Quality Control
- True or False: Urine chemical reagent strip readers can utilize any manufacturer's dipsticks.
- When an automated or semiautomated method is used to read urine chemical reagent strips, quality control testing must be performed:
- Summary Tables
- Test Principles, Reactions, and Interfering Substances
- References
- References
Additional Information
Level of Instruction: Basic
Intended Audience: Medical laboratory science and medical laboratory technician students and professionals, clinical laboratory personnel, and other medical personnel who perform urine dipstick testing at the point of care.
Author Information: Leah Westover, MPH, MLS(ASCP) is the Director of Sales and Marketing for MediaLab, Inc. Previously, she was the Director of Education and Outreach as well as the Medical Laboratory Science Program Director at St. Christopher’s Hospital for Children in Philadelphia, Pennsylvania. Leah holds a Masters in Public Health from Thomas Jefferson University.
Reviewer Information: Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor of Science and Master of Science in Medical Laboratory Science from Thomas Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist and Specialist in Hematology certifications through the ASCP Board of Certification. He was a professor at Thomas Jefferson University for seven years before transitioning into his current role as Education Developer at MediaLab. His areas of expertise and professional passions include clinical hematology and interprofessional education.