Urine Glucose and Ketone Tests
Reagent strip tests are used to monitor urine glucose and ketone levels and to screen for diabetes. Urine ketone tests monitor fat metabolism, help diagnose carbohydrate deprivation and diabetic ketoacidosis, and help distinguish between diabetic and nondiabetic coma. Urine glucose testing isn’t as accurate as blood glucose testing, and should be used only when blood glucose testing isn’t available. However, testing for ketones should be done when the patient is ill or glucose levels are elevated.1
Glucose oxidase tests (such as Diastix and Clinistix strips) produce color changes when patches of reagents implanted in handheld plastic strips react with glucose in the patient’s urine. Urine ketone strip tests (such as Keto-Diastix and Ketostix) are similar. All test results are read by comparing color changes with a standardized reference chart.
Equipment
Specimen container ▪ gloves ▪ glucose or ketone test strips ▪ reference color chart.
Wear gloves as barrier protection when performing all urine tests.
Implementation
Verify the doctor’s order for testing.
Check the patient’s history for medications that may interfere with test results.
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.5
Explain the test to the patient, and if he’s a newly diagnosed diabetic, teach him to perform the test himself.
Before each test, instruct the patient not to contaminate the urine specimen with stool or toilet tissue.
Put on gloves before collecting a specimen for the test.
Instruct the patient to void. Ask him to drink a glass of water, if possible, and collect a second-voided specimen after 30 to 45 minutes. (See “Urine specimen collection,” page 776.)
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