Urinalysis As A Highly Sensitive Procedure Sample College Essay

Urine Analysis

Urine analysis is a lab test prescribed to patients for one of several reasons. First, it may be used to determine the cause of numerous symptoms, such as abdominal pain, painful urination, back pain, and blood in the urine. Second, it is used to monitor the treatment process regularly. Third, it may be administered as a part of a routine check to assess the patient’s overall health. Urine analysis is a highly sensitive procedure, showing up to 100% sensitivity in some tests. However, the specificity of the test varies depending on the components included. Overall, it is considered valid for its purposes. The procedure of urine analysis differs depending on the desired data. The specimen is collected in a yellow top tube and submitted to the lab. If the abnormality is visually detectable (e.g. blood in urine), a visual exam is performed.

When it is necessary to analyze the proportion of red and white blood cells or the presence of bacteria, a microscopic examination is conducted. Finally, a chemical analysis (known as a dipstick test) is performed to measure acidity, the presence of proteins, and other chemical components. Normal results include clear yellow color, a pH of 4.5 to 8, glucose below 130 mg/d, and the absence of ketones and nitrites (MSD Manual, n.d.). The abnormalities detected during tests often imply one of the two conditions. The first one is kidney disease, which can be described as a gradual decline of kidneys’ functionality. The second condition is a urinary tract infection – a state in which a certain part of the urinary tract suffers from bacteria. Importantly, the findings of the analysis can be altered as a result of dietary habits, including liquid intake, effects of certain foods on urine color, dehydration, the use of medications, stress levels, and prolonged exposure of a specimen. It is recommended to educate patients on the principles of specimen submission before testing and the importance of regular tests after the test.

Liver Enzyme Levels (SGOT, SGPT, LDL) and Serum Amylase

Liver enzyme levels test is administered to detect the abnormalities in liver functionality, detect the onset of liver infections, assess the magnitude of side effects of certain medications, confirm the presence of liver disorders, or evaluate the progress of liver condition treatment. It should be pointed out that any given liver enzyme test is neither sensitive nor specific enough when used in isolation. Thus, these tests are typically used in combination, at which point they become sufficiently valid. The testing procedure involves blood sampling performed in a specialized facility or a hospital. A pressure device is used to increase blood pressure locally, after which a vessel is punctured, and blood is drawn. A green top tube is used in the process.

The normal reference values for the test are 5 to 40 units per liter of serum for SGOT and 7 to 56 units per liter of serum for SGPT (Davis, 2017). The normal values for LDL are between 100 and 130 mg/dL, with 100 or lower is the optimal level. It should be noted that the specified levels may vary depending on the procedures and techniques used by different healthcare providers. The abnormal test results usually imply the onset or exacerbation of a liver disease, which is associated with high levels of SGOT, SGPT, and LDL. It is uncommon for liver enzyme levels to decrease in response to a specific condition. However, high liver enzyme levels do not confirm the disease since they can be affected by several interfering factors. For instance, numerous medications can substantially increase test readings. Also, fluctuations of enzyme levels in healthy individuals may go above the identified maximum. Thus, it is recommended to educate the patients on the possible irregularities before the test and on the variety of implications after the results are available.

Serum Electrolytes (CO2, Chloride, K, Na)

A serum electrolytes test is intended to assess the state of fluid pH in the organism and is thus typically ordered as a part of a routine health check. The test is usually considered sensitive and specific for its purposes. Nevertheless, it is a common practice to include it into a comprehensive metabolic panel alongside creatinine and glucose tests to improve its validity. The procedure involves obtaining a specimen in the form of a blood sample using a venipuncture technique. A green top tube is used for specimen handling. Refrigeration is permissible for up to 7 days. Centrifugation is applied to prevent clotting. The normal reference values are 3.5 to 5 mg per liter for potassium, 135 to 145 mg per liter for sodium, 98 to 108 mg per liter for chloride, and 22 to 32 mg per liter for carbon dioxide (Farinde, 2014).

The abnormal results in the form of low sodium levels suggest the development of hyponatremia, whereas the excessive electrolyte levels imply hypernatremia, both of which can develop into a major health threat. Also, kidney disease, lung disease, and several heart conditions can be investigated with the help of the serum electrolytes test. However, the results can be compromised by several interfering factors. The most common factors are age differences and dietary habits. In particular, food content and caloric intake may elevate electrolyte levels above the upper normal range. Thus, the patients need to be educated on the effects of different medicines on test outcomes before the test. It is also recommended to outline the implications of abnormal results to ensure timely detection and proper treatment in the future.


Davis, C. P. (2017). Liver blood tests – Normal, low, and high ranges & results. Web.

Farinde, A. (2014). Lab values, normal adult. Web.

MSD Manual. (n.d.). Urine tests: Normal values. Web.

Advanced Practice Nurse’s Master Program And Skills

Every nurse practitioner must possess certain attributes of a leader to be able to exercise self-control and assess one’s personal experience. Master level nurses should have a clear vision of the future of their practice to be able to deliver the message to the team. In addition, leadership qualities include: acting in the right time and place, establishing lasting relationships with colleagues, enhancing self-confidence and the ability to encourage others, willingness to take risks, readiness for change and innovation, self-reflection, the ability to learn from mistakes, and respect for diversity at the workplace (Arnold & Boggs, 2015).

Thus, the major outcome of the course Leadership and Role of the APN is the capability of the nurse to fulfill all these requirements successfully. In this respect, it is demonstrative to assess whether the APN is prepared to meet the MSN program outcome #5, the MSN Essential IX, and the NP Core Competencies #2.

The MSN Program Outcome

The Master of Nursing program is intended to provide a well-organized, lifelong plan for achieving the best outcomes of both personal and profession development. It encompasses values concerning studies, work, and global participation. In most general terms, the achievement of the course outcomes allowed me to get prepared as a professional for the evaluation, selection, and implementation of the best practices in the provision of care (Grossman & Valiga, 2016).

In particular, I learned how to maintain personal and professional growth and ensure engagement in global issues by writing scholarly papers, taking part in conferences devoted to global medical problems, and assisting non-profit organizations in the local settings. There is also an opportunity to go to developing countries in order to provide care to underprivileged communities.

Furthermore, the completion of the course means that I can develop my professional plan using a historical perspective, which will make it possible for me to estimate the influence of nursing leaders on the quality of health care delivery and make conclusions based on other nurses’ experience (Grove, Burns, & Gray, 2014). I am now able to borrow their best practices for integrating them into my own.

In order to ensure that the process of building my career keeps the pace with my personal ambitions, I will use the ability to negotiate contracts learned during the course. I will need the skills of CV writing, undergoing interviews, obtaining certifications, winning privileges, and promoting my skills and knowledge.

Since the Master of Nursing program places a special emphasis on global participation, it will be helpful for me to be able to select leadership strategies that help foster interprofessional cooperation, especially in culturally diverse teams. Working with professional having different backgrounds requires good knowledge of ethical principles and diversity issues, which is one of the most important course outcomes (Anonson et al., 2014).

As far as scholarship and continuous learning are concerned, the completion of the course enabled me to make a personal contribution to the bulk of nursing knowledge and experience. Now, I can do my own studies, participate in systematic inquiry, and apply the results of other professionals’ practice. Moreover, I have learned how to share the findings of the research I conduct, using the most effective dissemination strategies.

MSN Essential IX: Master’s-Level Nursing Practice

MSN Essential IX: Master’s-Level Nursing Practice regards nursing practice at the master level as a wide range of activities, the outcome of which produces a significant impact on individual patients, communities, or entire systems. This implies that being a master level nurse, I must demonstrate a high level of nursing knowledge and skills as well as competence in related sciences and disciplines since all of them can assists with providing data that may be integrated into practice. Also, I must be able to ensure that both direct and indirect care is provided to the patient in due time and to the required extent (Weiss & Tappen, 2014).

Thus, the leadership course I took will be helpful mostly in integrating interprofessional collaboration, which is crucial for meeting the requirements set forward by the population. While it is still possible to satisfy the needs of an individual patient without resorting to the assistance of other professionals, the situation is different when the health of the community is at stake. Since nursing leadership skills are also required for active participation in policy-making, every nurse must be able to organize the process in such a way that each member of the interprofessional team performs his/her functions effectively (Bookey‐Bassett, Markle‐Reid, Mckey, & Akhtar‐Danesh, 2017).

Specialists from other fields (including policymakers, social workers, accountants, etc.) should act in a collaborative effort to be able to assess the conditions, do calculations, write financial reports, provide recommendations concerning the priorities of the community, perform health assessment, and organize care delivery. Each member of the team should have at least the basic knowledge of the work done by others to be able to discuss and improve the process (Pfaff, Baxter, Jack, & Ploeg, 2014).

The course, which I undertook taught me not only to organize the team work, but also to conduct negotiations, manage both physical and labor resources, and to assess the financial situation so as to be able to provide not only high-quality but also cost-effective care.

NP Core Competencies #2

The course Leadership and Role of the APN is directly related to the achievement of leadership competencies required for successful evidence-based practice. First and foremost, it helped me acquire visionary leadership skills that allow combining the best evidence with my own practical experience in order to ensure patient safety, constant improvement of the quality of care, and innovation. This implies that I have managed to master complex leadership roles including the ability to guide change.

As it has already been mentioned in the previous section, the collaboration with multiple stakeholders (including member of the team, patients, policy-makers, etc.) is ensured by the part of the course program related to interprofessional interaction. It makes a special emphasis not on exercising strict control over the process (which is an outdated understanding of leadership) but on innovative leadership, presupposing collective brainstorming, shared responsibilities, and collaborative decision making (Scully, 2015).

Cost effectiveness is ensured by the acquired ability to distribute the given resources in a fiscally sensible manner while maintaining the level of quality.

Innovation is one of the major issues learned through the course. In order to meet the standards of leadership, it is essential to be able not only to develop innovative solutions but also to prepare the team for the change, overcoming resistance, providing incentives, creating motivation, and ensuring commitment to the common goal.

The course has also taught me how to express myself both verbally and in writing since eloquence and persuasiveness are indispensible to the image of a good leader. Doing research I have developed skills allowing me not merely to disseminate results but also providing convincing arguments to support my findings.

Finally, since I had my nursing practice during the course, I was able to develop the last key competence, which concerns participation in professional activities and organizations.


Anonson, J., Walker, M. E., Arries, E., Maposa, S., Telford, P., & Berry, L. (2014). Qualities of exemplary nurse leaders: Perspectives of frontline nurses. Journal of Nursing Management, 22(1), 127-136.

Arnold, E. C., & Boggs, K. U. (2015). Interpersonal relationships-e-book: Professional communication skills for nurses. Amsterdam, Netherlands: Elsevier Health Sciences.

Bookey‐Bassett, S., Markle‐Reid, M., Mckey, C. A., & Akhtar‐Danesh, N. (2017). Understanding interprofessional collaboration in the context of chronic disease management for older adults living in communities: A concept analysis. Journal of Advanced Nursing, 73(1), 71-84.

Grossman, S., & Valiga, T. M. (2016). The new leadership challenge: Creating the future of nursing. Philadelphia, PA: FA Davis.

Grove, S. K., Burns, N., & Gray, J. (2014). Understanding nursing research: Building an evidence-based practice. Amsterdam, Netherlands: Elsevier Health Sciences.

Pfaff, K., Baxter, P., Jack, S., & Ploeg, J. (2014). An integrative review of the factors influencing new graduate nurse engagement in interprofessional collaboration. Journal of Advanced Nursing, 70(1), 4-20.

Scully, N. J. (2015). Leadership in nursing: The importance of recognising inherent values and attributes to secure a positive future for the profession. Collegian, 22(4), 439-444.

Weiss, S. A., & Tappen, R. M. (2014). Essentials of nursing leadership and management. Philadelphia, PA: FA Davis.

Peru As A Country With High Mortality Rates

Introduction: Peru

Although Peru has higher than average life expectancy and death rates (about 6.1 deaths on 1,000 people), infant and child mortality are high. Thus, the infant mortality rate is 18.4 (“The world factbook,” 2017). Moreover, Peru has the highest mortality rate in children with upper respiratory infections, and this fact conditioned my choice of the country for the research within this paper.


Located in Western South America between Ecuador and Chile, Peru is the country with an area of 1,285,2016 square kilometers (“The world factbook,” 2017). It borders Bolivia, Brazil, Chile, Columbia, and Ecuador. Due to the border with the South Pacific Ocean, its climate changes from desert to tropical depending on the region.


The population of Peru was estimated at 31,036,656 people as of 2017 (“The world factbook,” 2017). The country is home to such ethnic groups as Amerindian (who make up 45% of the population), mestizo (mixed Amerindian and white, who make up 37%), white (15%), and black, Japanese, Chinese, and others who make up 3% of the population (“The world factbook,” 2017). The median age of Peruvian citizens is 28. The country observes the growth of a population of 0.95%.


The process of economic development in Peru that became particularly active in recent decades is accompanied by the establishment of democratic principles (Oxford Business Group, 2017). At present, Peru is a presidential republic. The country with capital in Lima consists of 25 regions. The country received its independence from Spain in 1821 and has been developing its civil law system since then. The government is traditional and consists of executive, legislative, and judicial branches.


In the previous century, Peru was considered “a country scarred by economic and social upheaval” (Oxford Business Group, 2017, para. 1). However, in recent decades, Peru has been experiencing economic growth, which makes its economy as one of the fastest developing in Latin America. The growth of the Peruvian economy was an average of 5.6% per year in the period from 2009 to 2013 (“The world factbook,” 2017). Such an increase in the economy was empowered by high prices for minerals and metals exported by Peru internationally. Economic growth provided opportunities for the improvement of social spheres including healthcare. Thus, as of 2014, 5.5% of GDP was spent on health expenditures (“The world factbook,” 2017).

State of Health

Peru observes a very high degree of risk of infectious diseases. The most prevalent food or waterborne diseases include hepatitis A, typhoid fever, and bacterial diarrhea. Vector-borne diseases typical of the country are malaria, dengue fever, and Bartonellosis (“The world factbook,” 2017). The prevalence of obesity among the adult population in Peru is 19.7%, which is the 109th position in the world. HIV/AIDS prevalence rate is 0.3% as of 2016. 70,000 people living with HIV/AIDS in Peru, and 2,200 died in 2012 (“The world factbook,” 2017).

Culture and Traditional Medicine

The culture of Peru is a blend of Hispanic and native customs and traditions. The major native Peruvian cultures, such as Quechua and Aymara, have their indigenous languages (“Peru Overview,” 2017). Cultural traditions are preserved in dress and cuisine. Peruvian ancient architecture is presented by stone temples and salons that are mainly located in Machu Picchu, the lost city. Also, a specific feature of Peruvian culture is its music, which is a mixture of drums and wind instruments rooting back to pre-Colombian impacts and gentle stringed instruments of Spanish origin.

Traditional medicine is also an important aspect of Peru. Its roots go back to the traditions of Cupisnique culture (Bussmann, 2013). Traditional medicine is still popular and even economically significant in many countries. It can be explained by the lack of access to healthcare, in rural areas in particular. Thus, traditional and complementary-alternative medicine is widely used. In Peru, there is a National Program in Complementary Medicine that supports traditional treatment methods. The popularity of traditional medicine in Peru is probably conditioned by the great biodiversity of plants that make the basis for treatments (Bussmann, 2013). As of 2012, there was a database of 510 medicinal plants and 974 remedies of mixtures that are still developing.

Healthcare System and Delivery

Governmental health-related agencies and health regulatory organizations

In Peru, there is a decentralized health care system governed by five institutions. They are the Ministry of Health (MINSA); EsSalud; the Armed Forces (FFAA), National Police (PNP), and the private healthcare sector. MINSA is in charge of health services for 60% of the Peruvian population, EsSalud provides care for 30% of the population, and FFAA, PNP, and private sector together provide services to the other 10% of the population in Peru (World Health Organization, 2017). On the whole, the healthcare system comprises multiple organizations that provide health services and insurance. These organizations are frequently performing overlapping functions that are poorly coordinated. It results in many health workers occupied in several jobs simultaneously.

Healthcare personnel and hospitals

The country has been observing a tendency in an increase in the general number of healthcare professionals. However, growth in health worker outmigration that was observed simultaneously did not let it influence the difference in HRH densities. An increase was only observed in nursing (World Health Organization, 2017). Moreover, there is a growing demand for providers in general and medical specialists in particular. It is partially conditioned by the introduction of universal health insurance. As of 2017, there were 1.12 physicians per 1,000 people in Peru (“The world factbook,” 2017). No distinct information was found concerning the total number of physicians in the country.

Still, the average medical staff of a hospital includes 19 doctors, 15 nurses, and one intern (“Peru,” 2017). The same situation is about several beds in the hospital because no exact statistics are found on the issue. The healthcare infrastructure of Peru includes 883 hospitals (“Peru,” 2017). Out of these 883, only 9% of hospitals have more than 100 beds, and 12% have 50-99 beds. The majority of hospitals (79%) are small and can place only less than 50 patients. The average number of beds per hospital is 14 (“Peru,” 2017). The density is 1.5 beds per 1,000 people (“The world factbook,” 2017). On the whole, it should be mentioned that the geographic distribution of health workers and healthcare facilities is typical of Peru. Thus, areas closer to the coast are better provided with healthcare professionals while distant districts are in constant need of quality medical service.

The nursing education system and accrediting organizations

One of the major institutions involved in the preparation of nurses is the Professional School of Nursing of the National University of San Marcos (“Professional School of Nursing,” 2017). The School has achieved significant academic development that has enabled it to receive International Accreditation of the International Network of Assessors of the Union of Universities of Latin America and the Caribbean in 2011 and the National Accreditation in 2016. Its major mission is to prepare competent professionals, leaders, and researchers with thorough preparation and who will be ready for nursing practice. There is also a course in nursing at Augusta University dedicated to global health nursing. Peruvian students also go abroad to obtain a nursing diploma. Moreover, international internship programs are provided for those students who want to work in the conditions of a local healthcare facility.

Nursing associations

There is one accredited nursing association in Peru, Federación de Enfermeros de Peru. It officially represents and defends the Nursing profession; ensures that the practice of the profession and the life of nursing institutions are developed by the doctrine and with the norms contained in the Statute and Regulation, and in the Code of Ethics and Deontology; and promotes the social function of nurses that are to serve the individual, family, and community (CEP, 2015). Moreover, the association contributes to the competitive development of the nursing profession and encourages the scientific production of nurses. Finally, it participates in projects, plans, and programs in cooperation with state agencies, and national and foreign institutions in research studies and other health-related initiatives. Moreover, Peru is a member of the International Council of Nurses. The International Council of Nurses (ICN) unites over 130 national nurse associations. These associations present interests of more than 20 million nurses all over the world. The major goal of ICN is to ensure quality nursing care. Also, it encourages the development of nursing knowledge and respect for the nursing profession.

Health Priorities

The major health priorities for Peru are as follows. First of all, it is necessary to provide the growth of quality and availability of healthcare. It can be achieved by finding additional resources, including financial ones, to enhance the distribution of healthcare service. This priority also includes the provision of equal access to health care for all citizens. Another priority is related to industry and demands for the reduction of contamination as a result of heavy metal clearance, which also includes the provision of safe water for the citizens living in the areas with heavy industry. Another priority is the reduction of infant mortality rates that are high in Peru. Also, since Peru has the highest mortality rate in children with upper respiratory infections, it is important to develop strategies for its early detection and treatment. Finally, Peru demands the development of nursing education because the country needs healthcare professionals.

Conclusion: Nursing Implications

Nurses as active participants of the healthcare process can significantly contribute to the improvement of healthcare in Peru. First of all, they can provide patient education to teach the inhabitants of the contaminated areas the principles of safe living. Another education intervention is to work with school graduates to stimulate them to choose nursing as a career to improve the situation with healthcare professionals. Moreover, practicing nurses can contribute to the reduction of childhood mortality rates by giving more attention to the health of children, particularly children under five who are at greater risk. On the whole, nursing implications in the context of Peru and its healthcare system can be beneficial. Still, governmental support both at national and local levels is necessary to improve the situation in the country.


Bussmann, R. (2013). The globalization of traditional medicine in Northern Peru: From shamanism to molecules. Evidence-Based Complementary and Alternative Medicine, 2013, 1-46.

CEP. (2015). Qué hacemos. Web.

Oxford Business Group. (2017). Peru 2017. Country profile.

Peru overview. (2017).

Peru. (2017).

Professional School of Nursing. (2017). Web.

The world factbook. South America: Peru. (2017). Web.

World Health Organization. (2017). Peru. Web.

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