Nursing & Healthcare Programs

Measuring and Recording Output from a Urinary Drainage Bag

Written by Amanda R. McDaniel, MS, BSN, RN
Amanda is a BSN/RN with a MS in Physiology and a BA in English. She worked as a medical writer in the pharmaceutical industry for 11 years before pursuing a career in nursing. She now works as a nurse on a NeuroTelemetry unit and continues to write and edit on a freelance basis. Amanda’s LinkedIn

Accurate measurement of urination (aka, the output portion of intake and output) allows medical personnel to assess kidney and bladder function. Changes in output quantity or quality can reflect health status changes including new-onset infection or renal injury.

  1. Gather your supplies:
    • Gloves
    • Graduated measuring container. Make sure that the measurement on the container reflects the accuracy required by the doctor or institutional policy.
    • Antiseptic wipes
    • Paper towels or an absorbent pad
  2. Give the resident privacy by closing the door or curtain.
  3. Perform hand hygiene and don gloves.
  4. Lay the paper towels or absorbent pad on the floor below the urinary drainage bag.
  5. Place the measuring container on the towels or pad.
  6. Without allowing the drain to touch any part of the measuring container, open the drain and allow all urine to drain into the container.
  7. Clamp the drain and clean the end with an antiseptic wipe. Place the drain back in its holder.
  8. Note the amount of urine in the container. Note the characteristics of the urine. What is the color? Is there sediment or blood present? Does it smell strongly? Is there a decrease or increase in the amount of urine versus the last time the bag was emptied?
  9. Remove the paper towel or absorbent pad.
  10. Pour the urine into the toilet and rinse the measuring container. Pour the rinse water into the toilet and flush.
  11. Disinfect and store or dispose of the measuring container.
  12. Remove gloves and perform hand hygiene.
  13. Record the quantity and characteristics of the urine in the appropriate section of the resident’s chart per institutional or unit policy. Report any changes to the nurse per policy.

References

S. A. Sorrentino, & L. N. Remmert. (2012). Urinary elimination. In Mosby’s textbook for nursing assistants (8th ed., pp 399). St. Louis, MO: Elsevier Mosby.

More Resources

Measuring the Radial Pulse

The radial artery, located in the wrist, is easy to feel and an efficient location to measure heart rate. Changes to the rhythm or strength of the radial pulse can indicate heart disease, damage to the arm, or body fluid status. It is important to remember to check the radial pulse on both sides as differences between left and right can indicate injury or disease processes.

Moving the Resident from a Bed to a Stretcher or Gurney

Moving a patient from a bed to a stretcher can pose huge safety risks to both the patient and to the health care workers completing the transfer. Always use the appropriate amount of people to complete a transfer, which may vary according to the patient’s weight and/or the facility’s policy. In some cases, a mechanical lift may be needed.

Indwelling Catheter Care

Indwelling catheters allow urine to drain from the bladder. They are used when residents are unable to urinate on their own or when the process of cleaning the resident after urination would be difficult for the resident to tolerate (such as during end of life care). Caring for the catheter appropriately is a vital part of preventing infection and skin breakdown.

Orthopneic Position

Patients with respiratory illnesses such as chronic obstructive pulmonary disease (COPD) find ways to help themselves breathe more easily. This can include sleeping with extra pillows to keep them propped up or leaning forward to ease the work of breathing. The orthopneic position is one forward-leaning position used to help patients breathe comfortably when they are having difficulty.

Axillary Temperature with Electronic Thermometer

Compared to other temperature measurement methods, the axillary measurement is considered the least reliable. An axillary temperature measurement typically reads 0.5 to 1 degree Fahrenheit lower than an oral temperature reading [1]. For this reason, it is recommended to use this method only when other methods are contraindicated or when taking an axillary temperature is the safest method for the patient.

Measuring the Apical Pulse

The apical pulse rate is the most accurate non-invasive measurement of heart rate because it is measured directly over the apex of the heart. Apical pulse is preferred in cases when the radial pulse is difficult to palpate, when the pulse is irregular, greater than 100 beats per minute, or less than 60 beats per minute when measured by other means (electronic, radial, etc.).