Learning outcomes
By the end of this section, you should know how to:
▪ prepare the patient for this nursing practice
▪ collect the equipment required
▪ carry out testing of the urine.
Background knowledge required
Revision of the anatomy and physiology of the urinary system, with special reference to the formation of urine
Revision of the manufacturer’s instructions for the chemical reagents to be used
Revision of local policy on urine testing.
Indications and rationale for testing urine
Testing urine involves assessing the constituents of the urine by observational, biochemical and mechanical means:
▪ to aid in the diagnosis of disease
▪ to assist in the monitoring of disease and treatment
▪ to assist in the assessment of the health of an individual
▪ to exclude pathology.
Equipment
1. Clean, dry container for the urine sample
2. Bottle of reagent strips (Multistix SG8 and Multistix SG10 are the most commonly used reagent strips; Wilson 2005)
3. Jug for volume measurement
4. Bedpan or urinal
5. Watch with a second hand
6. Trolley, tray or adequate surface for equipment
7. Receptacle for soiled disposable items
8. Disposable gloves.
Guidelines and rationale for this nursing practice
▪ explain the nursing practice to the patient and obtain consent and co-operation to inform the patient about the practice and ensure that he or she is aware of a person’s rights as a patient
▪ awareness of different cultural attitudes towards handling and collecting body fluids and sensitivity to patients’ individual needs is essential (Solomon 2004)
▪ wash the hands to reduce cross-infection and contamination by the nurse’s and patient’s hands (Swales 2003, Jeanes 2005)
▪ testing urine does not require an aseptic technique, however it is essential that all equipment should be clean or disposable, and all precautions should be taken to prevent cross-infection
▪ nurses should wash their hands before commencing and on completing this nursing practice (Swales 2003, Jeanes 2005)
▪ micturition is an activity associated with privacy so collecting a specimen of urine is an unfamiliar and embarrassing experience for the patient (Solomon 2002)
▪ provide privacy and give an adequate explanation of the practice, this will be conducive to an uncomplicated collection of the specimen (Bardsley 2003)
▪ collect and prepare the equipment to ensure that the equipment is available and ready for use
▪ apply gloves to protect the nurse’s hands from contamination by body fluids
▪ measure the volume of urine if the patient has a fluid balance chart as this will ensure accurate fluid balance monitoring
▪ observe and note any sediment present in the urine as this may indicate an abnormality of the patient’s renal tract
▪ observe and note the colour of the urine as an unusual colour of the urine may indicate an abnormality
▪ note any smell as this may suggest an infection: infected urine has a foul, fishy odour