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

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Applying Restraints

Restraints have very strict guidelines for use due to the number of complications that can result. Use of restraints is associated with increased physical and psychosocial health issues. Restraints are only considered necessary when restraint-free alternatives have failed and the patient or others are at risk of harm without the restraints. It is illegal to use restraints for the staff’s convenience or to punish the patient.

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?

Dressing and Undressing a Patient

Patients who have suffered a stroke or have weakness or injury to one side of their body may struggle with dressing and undressing. In order to help these patients regain their strength and independence, it is important that the nurse’s aide only assist them as needed. The nurse’s aide may need to teach patients how to dress and undress safely with their limitations.

Fowler’s Position

Fowler’s position is used when a patient is eating, is having difficulty breathing, or is ordered by a doctor. This position is easily recognized because the patient will be sitting “straight up.” Semi-Fowler’s is sitting “half-way up,” and is used when patients cannot be laid flat, but wish to be in a more relaxed position than Fowler’s.

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.

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.