Any nurses out there, I have a ?

**MOM2EM&SETH** · 11-08-2006, 03:27 PM

I had to take dd2 to the dr today for possible UTI. Dr. said there was no sign of infection but that she had crystals in her urine. What exactly does that mean? He did go ahead and put her on Septra for 7 days with a recheck next week.

Her urine is so cloudy that you couldn't see through the collection cup. Sorry, TMI. Is there anything I should be looking for specifically as to explain this? Dr did not restrict any kinds of juices or anything like that. He also didn't give me any explanations for this cloudiness.

Thanks in advance for your help.

**Valerie in WA** · 11-08-2006, 07:18 PM

I'm a nurse, but I work in a very narrow field (NICU). I used to work general peds in hospital, but your story has my brow furrowed. Septra is an antibiotic, right? So why put her on it if there are no signs of infection? I believe that crystals are the precoursors to stones, but I might be wrong on that point. Cloudy isn't normal, but I'm not sure what it means in this case.

Typically, if there is infection, the initial 'dipstick' test shows white blood cells (the ones that fight infection) and maybe some blood (not visible blood, just shows up on the test). The blood is from irritation to the fragile lining of the urinary system. Gosh, I really think cloudy indicates infection.

Anyhow, if they suspect infection, they can send a drop of urine for culture. This is where you place a drop in a special dish with 'bacteria food.' If there's infection (bacteria), within 24-72 hours, there will be visible colonies (like those dots that grow on food left in the back of the frige). That's the only way to know for SURE if there's infection.

No need to restrict juices (that I'm aware of). Make sure she gets plenty to drink. Water is best, but if she'll drink a glass or two of cranberry juice a day, that certainly wouldn't hurt anything, and it could help.

Hopefully one of the other nurses will see this and reply too. I think Baxjul works in primary care and there's a gal named Heather (can't remember her user name) who is an nurse practitioner. She should know for sure.

**MOM2EM&SETH** · 11-08-2006, 07:33 PM

Thanks for your reply Valerie. I talked to my SIL who is studying nursing. She seems to think the antibiotic is precautionary for infection. She also said the dr. is probably concerned about stones since he kept reiterating that if dd2 worsens to call him immediately.

I would have felt better if Dr. had given me worse case scenario instead of leaving out the part about the possibility of a kidney stone. I know this dr personally and I'm sure he was just trying to prevent worrying on my part but the omission caused more worry. He is sending the urine speciman for culture in case this was just the beginning of an infection and we tested before the white cells would show up. I was just concerned about the presence of the crystals in her urine without the presence of infection. Now that I kind of know a little more, I feel a lot better. Needless to say, DD is showing no signs of any problems as she is running around as usual. I'm just glad it's about bedtime!

Thanks again for your time to reply!

**wantsabug** · 11-08-2006, 08:02 PM

I work now in an Internal Medicine office, have worked PED's and Family Prac.The Doc probably did a slide with urine and saw the crystals with a microscope. also probably saw other stuff. We always do a urine culture if burning,frequency etc or urine looks cloudy and start an initial antibiotic until we get the urine culture back, that way treatment is already started. Does she drink a lot of soda's,etc? If so she probably needs to cut back on those and drink more water.

**MOM2EM&SETH** · 11-08-2006, 09:08 PM

Carol, she doesn't drink soft drinks at all. Her big thing is chocolate milk. I make this with Ovaltine so she gets some extra vitamins. She probably drinks 5-6 8 oz cups of this a day along with a couple cups of juice. I can occasionally get her to drink a cup of water but not as often as I would like. I am going to start pushing her to drink more water.

Your description sounds just like what happened today at her dr. visit. They said her pH levels were elevated but nothing else showed up except the crystals present. There were not white or red cells present. They are sending the specimen for a culture and DD has to go back next week for a recheck.

Thanks for your time to calm my fears. She seems to be doing okay for now and she loves the flavor of the medicine so I don't think I will have a problem getting that in her for the next 7 days.

**Goodwin17** · 11-08-2006, 09:45 PM

Hey there. If your daugther's urine was cloudy, it could have been from the crystals. Crystals can indicate that kidney stones are possible. Your doctor most likely gave her the Septra as a precaution. If she were to have or get stones she would need the antibiotic because stones can cause small abrasions to the tubes that go from the kidney to the bladder. It is good that they are sending it out for a culture. The culture can more accurately tell just how many crystals are in the urine. I think the most imporatant thing to keep in mind is to force fluids. Lots of water is important now. I hope everything turns out ok. PM me if you have any other questions. I'm always happy to answer them.

**MOM2EM&SETH** · 11-08-2006, 11:09 PM

Thanks Heather! I know I can count on everyone here to calm my fears and nerves. I will push the water tomorrow since she is finally sleeping tonight. Thanks again for all your help everyone! This has really helped me to feel like I am more informed as to what I should be looking for. We will see how she does tomorrow.