The numerous small round objects found in the urine sample could be glucose and ketones. In urine, no or little glucose is found. However, in conditions of kidney damage and uncontrolled diabetes, glucose is evidenced in urine. Ketones develop in urine in cases where there is incomplete breakdown of fats. Ketones may also develop in cases where vomiting or diarrhea causes starvation. These small round objects may also be crystals from components such as calcium oxalate.
If the laboratory technician is not able to identify these small objects, the technician may suggest that the patient is suffering from diabetes or serious condition of disease. If not so, the patient has ethylene glycol ingestion or hypercalcemia. The cystine crystals would make the technician suggest that the patient has an inborn metabolism error. These crystals could be sediments of parasites, yeast cells and bacteria that illustrate that there is an infection of the genitourinary tract or external genitalia contamination. Such infections would result in the development of prostatovesiculitis, urethritis, and vaginitis that are caused by Trichomonas vaginalis parasite (Nurses Research, 2001). Such results should be sent to Urologist or a gynecologist depending on the gender of the patient.
The results obtain rule out that the patient is not suffering from trauma or conditions that cause excessive bleeding. Since there was no abnormal count of bacteria, it rules out that the sample of urine is not infected (Moffat, 2012). Presence of white and red blood cells rules out that the kidney of the patient is not clean. As such, the kidney is infected.
The next diagnostic procedure should be urinary calculi diagnosis. Urinary calculi (stones) represent insoluble substances that develop from mineral salts such as calcium phosphate, urate, calcium oxalate, cystine, and magnesium ammonium phosphate. Urinary calculi may appear in any location within the urinary tract and their size varies. Factors such as increment in mineral salts excretion, reduction of urinary volume, decrement in protective substances, pH changes, and urinary stasis cause the formation of the urinary calculi (Nurses Research, 2001). In the kidney, calculi are formed and are excreted as urine via ureter. However, not all calculi are excreted and some may call for surgical removal. To investigate for calculi, the sample urine is strained and an observation made on the strainer to identify any calculi signs.
If kidneys are involved, concentration and dilution tests will act as non-invasive diagnosis. Urine is diluted or concentrated in the kidneys with respect to intake of fluids. Excessive intakes results in excretion of more water in urine by kidneys while limited intake results in little excretion of water in urine. These tests call for explanation to the patient on restrictions on fluid and food intakes as the tests are being performed. For concentration test, the patient should be allowed to take a high-protein meal with 200 ml of fluid 24 hours prior to tests. The salt intake should be limited to ensure that the patient does not become thirsty. Urine samples should then be collected at 7:00 am, 9:00 am, and 11:00 am. The dilution test should follow the concentration test. However, in case it has to be performed alone, the breakfast should be withheld. The patient should be instructed to consume 1,500 ml of fluid within half an hour. Then, for four hours, urine samples should be collected after every 30 minutes.
References
Moffat, D. (2012). Urinalysis Interpretation. Retrieved from:
http://naturalhealthtechniques.com/urinalysis-interpretation.htm
Nurses Research. (2001). Laboratory Tests Interpretation. Retrieved from:
http://www.nurseslearning.com/courses/nrp/labtest/course/labtests.pdf
