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Urine Dipstick

In This Article

Advantages over urinalysis

  • Simple
  • Painless
  • No risk of infection
  • Cheap
 
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Disadvantages

  • Not precise

 You should only perform it after a full history and thorough examination!

 

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Indications

 
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Procedure

Mid-stream sample – means that the urine is not-contaminated from any bacteria on the skin
 
Men – retract the foreskin, clean the glans penis with a swab. Start to pass urine, and pass the first part into the toilet, then, without stopping the flow, catch some of the middle of the sample in a bottle. Once the bottle is full to the line, then you can continue to pass urine into the toilet
 
Women – hold back the labia, and clean the vulva with a sterile swab. Start to pass urine, and pass the first part into the toilet, then, without stopping the flow, catch some of the middle of the sample in a bottle. Once the bottle is full to the line, then you can continue to pass urine into the toilet
  • Don’t open the bottle until you are ready to take the sample.
  • The amount of urine is not that important. Tell patients they don’t have to completely fill the bottle!
  • The sample should be tested within 2 hours. If this is not possible, you may be able to preserve the sample to some extent by keeping in the fridge
 
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Testing a Urine Sample

  1. Wash hands, put on gloves
  2. Look at the bottle – check it is the right patient and the right date. You also want to know if it was taken in the last 2 hours – a crude way to know if it is recent is to see if it is warm!
  3. Look in the bottle – are there any precipitations?
    1. Does it look a normal colour?
    2. Normal – straw yellow
    3. Dark – bile pigments may be present due to dehydration
    4. Red – haematuria, menstrual blood?, food; e.g. beetroot and blackberries
    5. Green/blue – Pseudomonal UTI, triamterene (this is a potassium sparing diuretic), asparagus
    6. Orange – dehydration (bile pigments), phenothiazines, carrots
    7. Clarity – how clear is the sample?
    8. Cloudy – can be normal (especially in males), may also be bacterial infection (check the smell), WBC, lipids
    9. Frothy – this suggests proteinurea
    10. Is there anything in there that shouldn’t be in there?
    11. Make sure you keep the bottle on the tray, or trolley that it is given to you on! – e.g. in OSCE’s don’t lift it up and put it on the table!
  4. 4)      Open it and have a smell
    1. Ketones – smell like nail polish remover – diabetes
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