Testing urinary

Absorption of vitamin B12 can be investigated in several ways after oral delivery of radioactive vitamin B12 (e.g. containing Co) and subsequent measurement of radioactivity in faecal excretion, whole body counting or liver uptake, plasma radioactivity or the popular Schilling test. For the Schilling test, urinary excretion of radioactive vitamin B12 is measured 24 h following oral delivery, and impaired absorption may indicate intrinsic factor deficiency bacterial colonization of the small intestine (stagnant gut syndrome) or ileal disease. 

Fitzgerald RL, Ramos JM Jr, Bogema SC, Poklis A. Resolution of methamphetamine stereoisomers in urine drug testing Urinary excretion of R( )-methamphetamine following use of nasal inhalers. J Anal Toxicol 1988 12 255-9. 

As over 90% of the body s iodine is excreted in urine, urinary excretion of iodine is currently the most commonly-used biochemical marker of iodine intake. The determination of urinary iodine excretion in 24-h urine specimens is considered to be the most reliable method (Dunn, 1993) for testing urinary iodine levels. However, the accuracy and validity of the results will depend on the completeness of the 24-h collections hence, measures to assess the completeness of such collections, e.g., urinary creatinine excretion or para-aminobenzoic acid (Gibson, 2005), should be considered. 

Diagnostic criteria of the prune belly phenotype are wrinkled skin, thinness, and laxity of the abdominal wall (Fig. 17.1) in the absence of palpable testes. Urinary tract abnormalities are demonstrable only by diagnostic procedures, e.g., ultrasonography, and vary widely in appearance and severity. 

Relatively Httie is known about the bioavailabiUty of pantothenic acid in human beings, and only approximately 50% of pantothenic acid present in the diet is actually absorbed (10). Liver, adrenal glands, kidneys, brain, and testes contain high concentrations of pantothenic acid. In healthy adults, the total amount of pantothenic acid present in whole blood is estimated to be 1 mg/L. A significant (2—7 mg/d) difference is observed among different age-group individuals with respect to pantothenic acid intake and urinary excretion, indicating differences in the rate of metaboHsm of pantothenic acid. 

Dissolution of Human Urinary Calculi in Vitro. Five human urinary calculi containing various proportions of Ca3(P04)2, Ca(C204), CaC03, and MgNH4(P04) were subjected to similar dissolution tests at pH 7 (Table 11). The same dissolution patterns as those of the model phosphate and oxalate calculi are found. That is, for phosphate calculi no. 1-4, X is more effective than [18]aneN6 or EDTA and for oxalate calculus no. 5, EDTA is best. 

RISK FOR INEFFECTIVE TISSUE PERFUSION RENAL When the patient is taking a drag tiiat is potentially toxic to die kidneys, die nurse must carefully monitor fluid intake and output. In some instances, die nurse may need to perform hourly measurements of die urinary output. Periodic laboratory tests are usually ordered to monitor the patient s response to therapy and to detect toxic drag reactions. Seram creatinine levels and BUN levels are checked frequentiy during the course of therapy to monitor kidney function. If the BUN exceeds 40 mg dL or if the serum creatinine level exceeds 3 mg cIL, the primary health care provider may discontinue the drug therapy or reduce the dosage until renal function improves. 

The nurse must carefully monitor fluid intake and output because this drug may be nephrotoxic (harmful to the kidneys). In some instances, the nurse may need to perform hourly measurements of the urinary output. Periodic laboratory tests are usually ordered to monitor the patient s response to therapy and detect toxic drug reactions. 

When a UTI has been diagnosed, sensitivity tests are performed to determine bacterial sensitivity to the drugp (antibiotics and urinary anti-infectives) that will control the infection. The nurse questions the patient regarding symptoms of the infection before instituting therapy. The nurse records the color and appearance of the urine. The nurse takes and records die vital signs. A urine sample for culture and sensitivity is obtained before the first dose of the drug is given. 

When these drugs are given to the female patient with inoperable breast carcinoma, tire nurse evaluates the patient s current status (physical, emotional, and nutritional) carefully and records tire finding in tire patient s chart. Problem areas, such as pain, any limitation of motion, and the ability to participate in tire activities of daily living, are carefully evaluated and recorded in tiie patient s record. The nurse takes and records vital signs and weight. Baseline laboratory tests may include a complete blood count, hepatic function tests, serum electrolytes, and serum and urinary calcium levels. The nurse reviews these tests and notes any abnormalities. 

A favorable review of sulfosuccinate containing formulations is given in Ref. 17. The review was prompted by the U.S. Food and Drug Administration (FDA) when certain formulations based on other common surfactants gave rise to irritation of the urinary test. 

A recent method to screen the urine for alkyl phosphates as an indicator of exposure to organophosphate insecticides shows that the method can be used to determine environmental exposure to a specific organophosphate pesticide. The method was found to be sensitive, identifying low levels of exposure to insecticides in the environment by quantitation of urinary phosphates (Davies and Peterson 1997). The test is limited in that it is only useful for assessing recent exposure, due to the short half-life of the organophosphate pesticides. 

Fig. 5.8(a) Hypophysectomy abolishes urinary stimulation ablation of anterior pituitary removes neurocrine linkage via AOS to testes - - - = before — = after operation (from Johnston, 1985). 

If the test is positive, the urine is examined microscopically for red blood cells. If no red blood cells are found, a tentative diagnosis of myoglobinuria is made, serum chemistries are obtained, and the patient is held to rule out rhabdomyolysis. If the uric acid and creatinine kinase (CK) values are normal, and the patient is asymptomatic, he/she is discharged from the hospital. Routine toxicology tests include urinary PCP, serum alcohol, and hypnotic screen. 

Assess kidney function by evaluating a patient s signs and symptoms, laboratory test results, and urinary indices. Calculate a patient s creatinine clearance to evaluate the severity of kidney disease. 

At minimum, yearly laboratory evaluation of serum lipids, urinary microalbumin, and serum creatinine should be performed. If the patient is on a thiazolidinedione, liver function tests should be performed at least once a year. 

Initial screening tests to confirm the presence of hypercorti-solism and differentiate Cushing s syndrome from conditions with similar presentations include 24-hour urinary free cortisol determination and overnight low-dose dexam-ethasone suppression test (DST) (Table 42-9). 

---