Why do we need to do urine tests? How do elderly people in wheelchairs cope with urine tests?

Author: Zhang Yingqi, Chief Physician, First Hospital of Hebei Medical University

Reviewer: Guo Shubin, Chief Physician, Beijing Chaoyang Hospital, Capital Medical University

Urine examination (urinalysis for short) is a very common medical test item. By examining urine, a lot of useful information about the human body can be obtained, such as the health of the kidneys and urinary system, the metabolism of toxic and harmful substances in the body, etc.

Figure 1 Copyright image, no permission to reprint

1. Why do you need to do a urine test?

Urinalysis is one of the routine examination items in hospitals, which reflects the functions of multiple organ systems such as kidney function, urinary system, endocrine system, blood system, etc. The main contents of urine examination include urine color, pH, transparency, red blood cells, epithelial cells, white blood cells, protein, casts, protein specific gravity and urine sugar qualitative analysis.

Urine tests can detect whether the subject has urinary tract inflammation, stones or tumors, and can also be used to observe the recovery of patients after kidney transplantation. In addition, it can also be used to diagnose other systemic diseases in the body, such as diabetes, pancreatitis and hepatitis [1], as well as to conduct preliminary screening for whether a person has taken poison or drugs.

Doctors will often recommend a urine test as soon as possible if the following conditions occur.

1. Suspected urinary tract infection

If you experience varying degrees of frequent urination, urgency, pain, and back pain, it may indicate a urinary tract infection. In this case, it is best for the patient to go to the hospital for relevant urine tests, such as routine urine tests or urine culture.

2. There is swelling

If you wake up in the morning and find that your face, eyelids or lower limbs are swollen, and at the same time, your urine volume is less than usual, and your urine is sometimes accompanied by foam, it may indicate that you have a urinary system disease. At this time, you need to undergo urine routine tests, urine protein quantification and other related urine tests to diagnose the type of disease you have.

3. Other urinary system diseases

After patients have undergone B-ultrasound, CT or MRI examinations, those suspected of having urinary stones, tumors or kidney diseases usually need to undergo another urine test such as urine routine and urine culture. Some patients may need to collect urine for 24 hours for testing.

4. Sudden changes in urine volume

Some people usually have normal urine output, but suddenly their urine output decreases or becomes anemic, or their urine output suddenly increases. In this case, a urine test should be performed to find the cause and perform diagnosis and treatment [1].

2. How to collect urine for elderly people in wheelchairs

What should an elderly person with mobility problems do when he needs a urine test? This requires the patient to collect urine with the help of his family and in a wheelchair. The specific steps are as follows.

Figure 2 Copyright image, no permission to reprint

First , push the wheelchair to the bedside (it may be a hospital bed or an ambulance bed), with the back of the wheelchair flush with the foot of the bed, facing the head of the bed, with the injured or inactive side close to the bedside. Secure the wheelchair and flip up the footrest.

Second , slowly help the elderly sit up from the bed, and be careful to avoid sudden changes in body position, especially for elderly people who are dizzy or have low blood pressure.

Third , hold the elderly's waist tightly with both hands or hold their belt tightly, and move them from the bed to the wheelchair. Put on shoes, turn down the foot pedal, let the elderly step on the pedal with both feet, hold the wheelchair handrails, and sit as far back as possible. Then push the elderly to the toilet seat and fix the wheelchair.

Fourth , help the elderly place their feet steadily on the ground, climb onto the footrest, lean forward, let the elderly hug your neck with his arms, support the elderly's waist with both hands, and put your knees against his knees to help the elderly stand up and stand firmly.

Fifth , slowly turn the elderly to the toilet and help them unbuckle their belts. After they sit firmly on the toilet, let them hold the handrails with both hands. Place the bedpan to collect enough urine. Then wait at the door.

Sixth , after defecation, help the elderly to wipe the urethra, slowly lift them up, put on their pants, and move them to a wheelchair. Flush the toilet.

Finally, move the elderly person to the bedside, climb onto the pedal, slowly help him up, hold the belt tightly, let the elderly person stand firmly, move the wheelchair back, move him to the bed, and tidy up his clothes.

3. Precautions for urine test

1. It is best to collect the first morning urine for urine testing. The accuracy and sensitivity of the test are higher, and the amount of urine each time should be around 30 ml and not less than 10 ml.

2. Before collecting samples, you should control your diet and avoid drinking strong tea, coffee, or juice with too much sugar, so as not to affect the test results.

3. Do not collect urine samples while taking medication, otherwise it will affect the test results.

4. Patients should collect midstream urine when sampling. The flow rate of forestream and posterior stream urine is relatively low, and the probability of being contaminated when flowing through the perineum and other parts is high, which can easily lead to errors in the test results; while the flow rate of midstream urine is relatively high and relatively cleaner, so midstream urine is the most suitable as a test sample.

Figure 3 Copyright image, no permission to reprint

5. If the patient is a male, do not mix prostatic fluid and semen into the sample. If the patient is a female, do not mix vaginal secretions into the sample [1].

Urine tests can reveal many physical indicators and whether someone has certain diseases. We should pay attention to urine tests and have regular physical examinations. For elderly people with inconvenient legs and feet, family members should understand their physical condition and be careful when helping them collect urine to prevent accidents.

References

How to do a good urine test and what are the precautions. Ying Li. Health Care Wenhui. 2020, (10): 81-82.