CHAPTER 9 Genitourinary System^395
Prostate Specific Antigen (PSA) Test
This test measures the level of PSA in the blood. The level will be elevated in
patients with BPH (benign prostatic hypertrophy) or prostate cancer. Elevated
PSA levels alone do not give doctors enough information to distinguish between
benign prostate conditions and cancer; however, the doctor will take the test
results into account when deciding whether to order additional screening for
prostate cancer. The test is also used to monitor treatment and to test for recur-
rences of prostate cancer.
Before the test—Explain to the patient that rectal and prostate exams, ejaculation,
UTI, and prostatitis will all elevate a PSA level.
24-Hour Urine Collection
This is a diagnostic test that involves collecting a patient’s urine for 24 hours. It is
typically used to measure volume and various other factors of kidney function as
well as to determine the daily elimination of such substances as proteins, elec-
trolytes, etc.
Before the test—Explain to the patient that the test is started in the morning.
Discard the first voided specimen, then save subsequent specimens, ending with
the first voided specimen the following day. The urine collection jug should be
kept on ice or under refrigeration.
Urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It
involves a number of tests to evaluate the urine specimen for appearance, color,
clarity, pH, specific gravity, and the presence of bacteria, blood, casts, glucose,
ketones, leukocytes, proteins, RBCs, and WBCs. The tests are used to confirm
symptoms of a UTI, to check diabetics for excess glucose levels, and to monitor
the kidney function of renal patients.
Before the test—Explain to the patient that many drugs affect a urine specimen.
Some samples, as when ascertaining the presence of an infection, may need to be
“clean catch” or “midstream clean” collection. The perineum or urethral opening
should be cleansed, and the voiding stream started. Without stopping the stream,
position the sterile container into the flow of urine. When the container is more