Performing urine testing: Clinical skills notes

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 nitrites, 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 urobilinogen, which could be a sign of liver disease.

Figure 1: Why and where urine testing is conducted.

COMMON CARE TIPS

Always double-check the client’s identity to make sure the procedure is performed on the right person.
At all times, respect the client’s privacy and modesty by closing the room’s door and all window covers, as well as ensuring the client is properly covered.

Figure 2: Common care tips for urine testing.

SUPPLIES & PROCEDURE

Supplies

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
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.

Figure 3: Supplies needed when performing urine testing.

Procedure

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.
Assist the client with urination as needed.
- For clients with phenotypically female genitalia who can’t get out of bed, a bedpan can be used.
- For clients with phenotypically male genitalia who can’t get out of bed, you can use a urinal.
- A bedside commode can be used by clients with limited mobility but who can still get out of the bed.
- 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 the client is done, provide them with tissue paper or paper towels to clean themselves, or you might need to assist them with perineal care.
Before using the reagent strips, 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.
Clean and return the equipment to the right place.
Dispose of your gloves and wash your hands.

DOCUMENTATION

When performing urine testing, report the following to the healthcare provider:

if the client has any new or worsening pain or difficulty urinating
if you notice if the urine is discolored, cloudy, or has an abnormal odor
sometimes, the urine output
the test results

Document:

the date and time
the test results
any observations regarding the quantity and quality of urine

Author: Maria Emfietzoglou, MD

Editor: Jannah Amiel, MS, BSN, RN

Illustrator: Elijah Lee, MScBMC

Illustrator: Ursula Florjanczyk, MScBMC

Performing urine testing: Clinical skills notes

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