Nurse Pete is reviewing the report of a client’s routine urinalysis. Which value should the nurse consider abnormal?
A. Specific gravity of 1.03
B. Urine pH of 3.0
C. Absence of protein
D. Absence of glucose
Correct Answer: B. Urine pH of 3.0
Normal urine pH is 4.5 to 8; therefore, a urine pH of 3.0 is abnormal. Urine-specific gravity normally ranges from 1.002 to 1.035, making this client’s value normal. Normally, urine contains no protein, glucose, ketones, bilirubin, bacteria, casts, or crystals. Red blood cells should measure 0 to 3 per high-power field; white blood cells, 0 to 4 per high-power field. Urine should be clear, its color ranging from pale yellow to deep amber.
Option A: Normal USG is 1.002-1.035 (usually 1.016 to 1.022). The urinary specific gravity (USG) and osmolality are of special importance because they indicate the kidney’s capacity to dilute or concentrate urine. USG is defined as the ratio between the density of urine and the density of an equal volume of pure distilled water.
Option C: In normal conditions, the glomerular capillary wall is permeable to molecules of less than 20,000 Daltons. Most of the small fraction of filtered proteins are reabsorbed and metabolized by the proximal tubule cells. Thus, proteins are normally present in urine in trace amounts.
Option D: Glycosuria occurs when the filtered load of glucose exceeds the tubular cells’ ability to reabsorb it, which normally happens at a glucose serum concentration of around 180 mg per dL. Furthermore, nitrites are not normally found in urine, and it is highly specific for urinary tract infection. However, due to its low sensitivity, a negative result does not rule out infection.
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