To keep a keen check on the urinary output of some of the patients; it becomes an extremely vital duty of the CNAs. CNAs have to keep on tracking the daily urinary output of such patients to ensure, whether their kidneys are fully healthy and well functioning or not. Under this task, a CNA has to quantify and note down the urine output of the patient on a daily basis.
Points To Remember:
1. In general, a certified nursing assistant has to calculate and trace the patient’s urinary output in two situations:
- If a patient uses a bedpan and non-ambulatory.
- If the client wears an indwelling catheter.
2. Do not forget to wash your hands with soap properly, before staring the activity.
3. To begin with, you must greet the client in a polite way.
4. Describe the patient initially that you are going to quantify and note down their urinary production.
5. Always remember that anynegligence or slip-up in the measuring process can cause inaccurate results, which can make the patient fell extremely sick or the worst it can lead to death, as well.
6. Before leaving for the day, make sure you have checked the patient’s catheter bag. Even if, the contents available in the bag are in quite less, in quantity; still you need to take the most accurate reading.
7. You can also keep a record of the liquids consumed by the patient in a day to make the results more significant for measuring and recording.
8. You have to add up all the liquids and other things that can turn up into liquids after consumption like, popsicles, ice-cream, etc.
9. This is the responsibility of the CNA, who has been assigned to notice the urinary output of a patient as his/her in charge; to keep a keen check on the intake and out take of liquids consumed by that patient. The CNA must personally bring the meal tray for that patient, so that the in charge nursing aide will be able to calculate the quantity of liquids taken by the client.
10. A CNA also needs to take account of the nourishment as well while doing the intake measurements.
11. As a CNA, you must never do the fault to follow some other person’s advice about the amount your patient should intake or drink at a time.
12. Do not miss the recording or measuring of the urinary produce ever. This is considered as illegitimate in the context of health care.
13. The last job of the day for a CNA is to check and update the medical chart of their clients, especially whom they are in charge for.
14. To copy simply the last calculated input and output and marked it down, as the new measured result is entirely against the principles of a CNA.
Stepwise Procedures to Go By For Measuring and Copying the Urinary Output of a Patient, Who Makes Use of a Bedpan
Step 1-Placing the linen under the patient’s butts
First of all, spread the bed pads under the patient’s buttocks. This avoids the dispersal of any liquid on the patient’s bed linens directly.
Step 2- Positioning the bed pan
Now, you need to position the bedpan exactly under the client’s buttocks by making him/her slightly turned to one of their sides.
Step 3- Position the patient correctly
Get the patient in the supine position and ask him/her to move legs at a distance (if they can). If the patients are weak to do so then, you must do it for them in order to ensure that whether the bedpan has been positioned correctly or not.
Step 4- Setting the bed level
After this, check whether the bed is set at a comfortable level or not. Move the head side of the bed little upwards for making it more convenient for the patient.
Step 5- Giving Privacy
Draw all the curtains to provide complete privacy to the client and get away for a while, so that the patient can urinate on the bedpan without any hesitation.
Step 6- Again cleanse your hands and wear gloves
Once the patient has done the urination, you need to wash your hands and wear on gloves once again. This helps to remove the micro elements which might have come in your direct contact by means of any equipment or patient’s urine.
Step 7- Now make the bed level even
Make the raised side of the bed even by bringing it back to its standard position.
Step 8- Turn the patient on one side carefully
Slightly assist the patient to turn at one of the bed sides with care. Take care that the urinated content of the bedpan should not be dispersed on the bed at all. Make sure, you also hold the bedpan while the client is turning to one of the sides. If, somehow the urine contents fall on the bed, you have to replace the bed linens immediately.
Step 9- Placing the bedpan on a flat surface
Take the bedpan at a distance from the patient and keep it on an even surface, once you have took it out under the patient’s buttocks.
Step 10- Cleaning the genitals of the patient
With the help of a small wash cloth or a linen towel, you have to clean the genitals and the butts of the patient. Make sure, you do it properly to keep the client away from infections.
Step 11- Pouring of the urinary content
Transfer the urinated contents from the bedpan to the measuring container till the last drop falls. Do not spill the contents at all.
Step 12- Washing the bedpan
While, washing the bedpan throw the rinsed water into the toilet. Keep the used equipments into designated dirty area.
Step 13- Keeping the measuring container at an even surface
Keep the urinary container at an even surface to measure the amount correctly.
Step 14- Memorizing and Recording the digits
Observe where the level of urinated content has reached on the scale made on the measuring container.You remember or ask someone else to note down the numbers for you.
Step 15- Throwing of urinated contents
Now, you need to empty the measuring container by throwing the contents of the container into the toilet.
Step 16- Disposing the gloves and washing your hands
At this time, you can remove the gloves and go for thorough hand washing.
Step 17- Copying of the measured values
Once, you have clean your hands you can copy down the measured values on the sheet. Do not forget to convert the digits accordingly to match it up with the assessor’s marked values.
Steps 18- Make the client comfortable
Get the client into a comfortable position on his/her bed. Also, if the patient wants to clean his/her hands, give a hygienic wet cloth or a small hand towel.
Stepwise Procedure to Measure and Record the Urinary Output, of a Patient Wearing an Indwelling Catheter
Before starting this procedure, you have to see the numeric labelling on the side of the bag to find out the urinary output of the patient. The usual urinary output should lie in between 30 to 400 CCS an hour. In case, the output is quite higher or lesser as compared with the given range; then you need to notify the supervisor nurse about it right away.
Step 1- Observe the colour of the urine minutely
Initially, you have to observe keenly about the colour of the urine. Ideally, the urine should look pale yellow in colour and clean. However, if you notice something abnormal in the urine bag, you must let know the nurse immediately.
Things that will show you some of the malformations in the urine are –
a. It can be unclear or cloudy
b. It might have spots of sediments
c. Its colour may be abnormal, like dark amber, pinkish or greenish.
Step 2- Make sure you wash your hands twice or thrice
Washing your hands is again a great requirement for conducting this activity. However, this might possible that you have to cleanse your hands a more than one time, during this process.
Step 3- Greet the patient
Now you must also greet the client ideally and explain about the procedure.
Steps 4- Keep the privacy
Draw the curtains to maintain the privacy.
Step 5- Gather the necessary belongings
Take the linens, bed pads, wash cloth, towels and other necessary belongings with you, before starting this activity. Keep all these on the patient’s table.
Step 6- Wear hand gloves
Do not forget to wear hand gloves prior to starting this process.
Step 7- Keep the measuring container on the floor
Place the bath linen sheet on the floor just next down to the indwelling catheter patient. Keep the measuring container and paper towels on the linen sheet.
Step 8- Drain out all the urinary content
Open the tube’s tap to drain all the urinary content into the measuring container. Give time to drain out the whole urinary contents into the container till the last drop fall. After the content is out close the tube cap again. You may also replace the urine bag with an empty one, if instructed to you.
Step 9- Keep the container at an even surface
Keep the urinary container for measuring the quantity at a side, so that it should not fall.
Step 10- Write the measured digits
Mark the values on the sheet.
Step 11- Drain the urine in the toilet
Once you have noted down the measurement from the container’s scale, you need to throw the urine into the toilet. However, if you find any abnormalities, you can keep it for further testing and pass it to the supervisor nurse.
After you are done with the process, you must dispose your gloves and rinse your hands well. As while performing this activity, you might have come up to direct touch with the devices or the patient’s urine that can convey various germs to you.
- Every time you calculate the values of the urinary output of a supine or any other patient; make sure you do it accurately.
- The record copied by a CNA or a nurse assists in discovering the big or small complications involved in the client’s condition throughout the treatment process.
- You need to conduct the process minutely and carefully, as the recorded information helps in identifying the urinary dysfunctions, when they are in their early phases.
- This way, along with the kidney other vital body organs of a client can also be prevented from being possibly damaged.
- It is also a CNAs responsibility to be able to find out the symptoms or spots of infections in the patient’s urine.
- Remember, as soon as you find signs of infections in the urine, its treatment will be started sooner with fewer difficulties to cure the patient in early point in time.
- However, if a CNA is not able to find out the problems or indications earlier, then it can cause severe pain to the patient, and the cure will be more complex.
- To monitor and record the urinary output correctly on a regular basis is an essential task of a CNA.
We have given you the videos to learn the stepwise clear demonstrations of how this skill is being done for both cases.