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 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.).

Rectal Temperature with Electronic Thermometer

A rectal temperature provides the most accurate core body temperature reading compared to other non-invasive methods. This makes a rectal temperature desirable; however, this procedure comes with more patient discomfort and more safety risks (bowel perforation, mucosal damage, and/or vagus nerve stimulation) than the other temperature measurement methods.

Measuring Blood Pressure

Many factors can interfere with obtaining an accurate blood pressure. The most common mistakes that lead to inaccurate blood pressures are a result of improper technique, including: not supporting the patient’s arm, using the wrong sized cuff, positioning the cuff too low on the patient’s arm, improper positioning of the cuff’s artery marker, and attempting to measure blood pressure through clothing.

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.

Offering the Bedpan

When a resident is bed-bound, they must use a bedpan to urinate and defecate. This can be embarrassing for the resident, so it should be done with sensitivity to the resident’s privacy and dignity. There are two types of bedpans. A regular bedpan is the deeper and more rounded of the two. A fracture pan has a relatively flat upper end with a trough at the lower end. Fracture pans are used for residents who have difficulty, or restrictions against, moving their hips and/or backs.

Putting on Personal Protective Equipment

Personal protective equipment is worn to protect the mouth, nose, eyes, clothing, and skin from unwanted pathogens. In the health care setting, a patient’s condition often prompts the use of personal protective equipment; however, a health care worker is able to wear personal protective equipment whenever he or she deems it is necessary (e.g., during procedures with the potential for excessive contact with bodily fluids).