A patient’s urine is cloudy, is amber, and has an unpleasant odor. What problem may this information indicate that requires the nurse to make a focused assessment?
A. Urinary retention
B. Urinary tract infection
C. Ketone bodies in the urine
D. High urinary calcium level
Correct Answer: B. Urinary tract infection
The urine appears concentrated (amber)and cloudy because of the presence of bacteria, white blood cells, and red blood cells. The unpleasant odor is caused by pus in the urine (pyuria). Uncomplicated urinary tract infection (UTI) is a bacterial infection of the bladder and associated structures. These are patients with no structural abnormality and no comorbidities, such as diabetes, immunocompromised, or pregnancy. Uncomplicated UTI is also known as cystitis or lower UTI.
Option A: These clinical manifestations do not reflect urinary retention. Urinary retention is evidenced by supra pubic distention and lack of voiding or small, frequent voiding (overflow incontinence). The mechanisms of acute urinary retention can include outflow obstruction, which can be mechanical such as from physical narrowing of the urethral channel. The other dynamic is from an increase in the muscle tone within and around the urethra as in benign prostatic hypertrophy and hyperplasia.
Option C: These clinical manifestations do not reflect ketone bodies in the urine. A reagent strip dipped in urine will measure the presence of Ketone bodies. If the cells don’t get enough glucose, the body burns fat for energy instead. This produces a substance called ketones, which can show up in the blood and urine.
Option D: These clinical manifestations do not reflect excessive calcium in the urine. Urine calcium levels are measured by assessing a 24-hour urine specimen. If urine calcium levels are too high or too low, it may mean that the client has a medical condition, such as kidney disease or kidney stones. Kidney stones are hard, pebble-like substances that can form in one or both kidneys when calcium or other minerals build up in the urine. Most kidney stones are formed from calcium.