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

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.

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.).

Nail Care (Fingers and Toes) for CNAs

Nail care of both the feet and the hands should be performed as part of the patient’s daily hygiene routine. The status of the patient’s nails can reflect their overall health. Nail issues can also lead to infection that can spread systemically (ex, ingrown nails or fungus). You should never clip a patient’s nails with nail clippers, and always review your institution’s policy about what nail care is allowed.

Perineal Care of the Female Resident

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Proper technique is important for maintaining hygiene, preventing infection, and avoiding skin breakdown. Because of the close proximity between a woman’s urethra, vagina, and anus, it is essential to only wipe in a front to back motion. Wiping in the opposite direction is associated with a greater risk for developing a urinary tract infection.

Sim’s Position

The position a patient is placed in is often ordered by the physician, or recommended by a speech, occupational, or physical therapist. The position dictates whether a patient is sitting, lying, standing; or if they are on their side, back, or prone (face-down). Positioning is also determined by the patient’s current needs, such as: Are they eating? Sleeping? Having surgery on their back? Are they receiving nutrition through a nasogastric tube?