Genitourinary: Performing urine testing (for nursing assistant training)

Urine testing is a type of urinalysis where urine is checked for several chemical properties. Chemically treated, paper strips are dipped into a urine specimen and react with certain substances that can be found in the urine.

This reaction causes the reagent strip to change color. And then the color is compared with a color coded chart that comes with the strips.

Urine testing is easy to perform and it is typically used for clients receiving medical care in their home or in long term facilities where more detailed laboratory testing is not available.

Urine testing can be used to check urine ph and the levels of nitrates, red blood cells, white blood cells, proteins, ketones and glucose.

Abnormal test results can be caused by various diseases that damage the kidneys or urinary tract such as diabetes, hypertension, kidney stones or kidney and urinary tract infections.

It can also detect abnormal levels of bilirubin and neuro bilinogen, which could be a sign of liver disease. Now, before we go into the procedural details of urine testing, here are some common care tips, always double check the client's ID to make sure the procedure is performed on the right person based on your scope of practice and the facility protocol.

A nursing assistant can perform urine testing under the directions of a nurse who will provide you with instructions at all times, respect the client's privacy and modesty by remembering to close the room's door, all window covers and ensuring the client is properly covered when performing urine testing.

First gather the supplies you'll need including gloves, a specimen container, tissue paper, paper towels, a watch that measures seconds and a bottle with reagent test strips.

You may also need a bedpan, a urinal, a bedside commode or a container to collect urine from the catheter, wash your hands and put on gloves.

Provide the client with a specimen container and ask them to void into the container. You usually need a random urine specimen.

However, a double voided specimen may be needed for glucose testing. In this case, ask the client to void, discard the urine, ask the client to drink a glass of water and then have them void again.

Ok. Now assist the client with urination as needed for biological females who can't get out of bed.

A bedpan can be used for biological males who can't get out of bed. You can use a urinal which looks kind of like a plastic jug.

A bedside commode can be used by clients with limited mobility but who can still get out of bed. Now, for clients with catheters, you can obtain a urine specimen from the catheter port give the client time to urinate.

A person might be too embarrassed to urinate when you're there. So leaving the room or looking away might help but stay nearby in case they need aid after they're done, provide them tissue paper or paper towels to clean themselves or you might need to assist them with perineal care.

Now, before using the reagent strips, don't forget to check the expiration date on the bottle, do not use expired strips or strips that are discolored, take a strip and then close the bottle tightly.

Make sure not to touch the end of the strip because that's the test area, dip the end of the strip in the urine and then remove it immediately tap the strip gently against the container to remove excess urine.

Make sure to hold the strip horizontally to avoid mixing the chemical reagents compare the color of the strip with the color chart that comes with the bottle for some results such as glucose, you need to wait and read the results after some time, document the results and then discard the urine.

Finally make sure to clean and return the equipment to the right place, dispose of your gloves and wash your hands. Now, when assisting with urine testing, there are a couple of things you should report to the nurse straight away.

First, if the client has any new or worsening pain or difficulty urinating. Next inform the nurse if you notice the urine is discolored cloudy or has an abnormal odor.

Sometimes a nurse will ask you to report the urine output, finally report the test results to the nurse. When you assist with urine testing, document the date and time the test results and any observations regarding the quality and quantity of urine.

All right, as a quick recap, urine testing can be used to check for properties of the urine like PH and the presence of blood proteins, glucose, white blood cells, nitrites, bilirubin and urobilinogen reagent trips are dipped into a urine specimen and react with substances that can be found in the urine.

This reaction causes the reagent strip to change color and then the color is compared with a color chart after the procedure.

Make sure you report any abnormal observations and results and leave proper documentation.