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or profuse sweating reduces urinary output; a high-protein diet tends to increase it. Daytime urine output is normally two to four times greater than nighttime output. PRESERVATION OF URINE SPECIMENS To delay decomposition of urine, use the following methods of preservation:  Refrigeration  Preservatives Hydrochloric acid Boric acid Glacial acetic acid Other preservatives used include formaldehyde, toluene, and thymol. The preservative used must be identified on the label of the container. If no preservative is used, this, too, should be noted. NOTE: Before adding a preservative to a urine specimen, contact the laboratory performing the test to find out what preservative to use and the quantity to add. Preservative requirements vary from laboratory to laboratory. ROUTINE URINE EXAMINATION A routine urinalysis includes the examination of physical characteristics, chemical characteristics, and microscopic structures in the sediment. A sample for urinalysis (routine and microscopic) should be at least 15 ml in volume (adult), and either a random or first morning specimen. Children may only be able to provide a small volume, but 10-15 ml is preferred. Physical Characteristics Physical characteristics evaluated during a routine urinalysis include color, appearance, and specific gravity. COLOR.—The normal color of urine varies from straw to light amber. Diluted urine is generally pale; concentrated urine tends to be darker. The terms used to describe the color of urine follow.  Colorless  Light straw  Straw  Dark straw  Light amber  Amber  Dark amber  Red The color of urine may be changed by the presence of blood, drugs, or diagnostic dyes. Examples are:  red or red-brown (smokey appearance), caused by the presence of blood.  yellow or brown (turning greenish with yellow foam when shaken), caused by the presence of bile.  olive green to brown-black, caused by phenols (an extremely poisonous compound, used as an antimicrobial agent).  milky white, caused by chyle. (Chyle, which consists of lymph and droplets of triglyceride, is a milky fluid taken up by lacteal vessels from the food in the intestine during digestion.)  dark orange, caused by Pyridium® (a topical analgesic used in the treatment of urinary tract infections).  blue-green, caused by methylene blue (used as a stain or dye for various diagnostic tests). APPEARANCE.—Urine’s appearance may be reported as clear, hazy, slightly cloudy, cloudy, or very cloudy. Some physicians prefer the term “turbidity” instead of “transparency,” but both terms are acceptable. Freshly passed urine is usually clear or transparent. However, urine can appear cloudy when substances such as blood, phosphates, crystals, pus, or bacteria are present. A report of transparency is of value only if the specimen is fresh. After standing, all urine becomes cloudy because of decomposition, salts, and the action of bacteria. Upon standing and cooling, all urine specimens will develop a faint cloud composed of mucus, leukocytes, and epithelial cells. This cloud settles to the bottom of the specimen container and is of no significance. SPECIFIC GRAVITY.—The specific gravity of the specimen is the weight of the specimen compared to an equal volume of distilled water. The specific gravity varies directly with the amount of solids dissolved in the urine and normally ranges from 1.015 to 1.030 during a 24-hour period. 7-34


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