CNA Skill: Measuring And Recording Urinary Output

In some patients, it is important to monitor the urinary output to ensure the kidneys are functioning normally.  To do this, the nurse’s aide will be asked to check and record urine output.  Before beginning, make sure you have properly washed your hands.  There are two situations that you will be asked to check urinary output- for patients who are wearing an indwelling catheter, and for non-ambulatory patients who are using a bedpan.

To check urinary output for a patient with an indwelling catheter:

1. Use the markings on the side of the collection bag to determine output.  Normal output is between 30 and 400 ccs per hour.  If the patient is producing significantly more or less than this, notify the nurse.
2. Note the appearance of urine.  It should be clear and pale yellow in color.  If any abnormalities are observed, report this information to the nurse.  Abnormalities include cloudiness, sediment, or unusual colors such as dark amber, pinkish, or green.
3. If you observe blood or an unusually bad odor, you should also notify the nurse.
4. Empty or replace the bag if directed, then wash your hands.

To check urinary output for a patient using a bedpan:

1. When the patient has finished using the bedpan, ensure that the patient has sufficient privacy.  Wash your hands and put on gloves.
2. Lower the head of the bed so the bed is flat, and turn the patient onto his or her side.  Support the bedpan to prevent leakage.  Remove the bedpan and set it aside.
3. Ensure the patient’s buttocks and genital area is properly cleaned, and then help the patient into a comfortable position.
4. Measure urine output, and then dispose of the urine in the toilet or as directed.
5. Remove gloves, and wash hands.

By monitoring urinary output, you will be able to assist the medical team in catching potential complications as the patient recovers.  Early detection of urinary dysfunction can prevent damage to the kidneys or other organs.  You may also be able to detect signs of infection, which can be very painful if not treated.

Expert Tip by Tanya Glover, CNA

After 12 years I have seen it all. I have seen lazy aids and dedicated ones. I have had patients who needed input and output recorded and those who did not. For those who need this service, please realize just how important it is. Let me tell you about lazy aides. At the end of their shift when it is time to do their paperwork and charting, they will look back at the last week of input and output numbers and simply put the same thing for their shift. This is a big NO NO! It is important to understand the significance of this task.

Patients who have caths are typically the ones requiring this charting information. We need to know if their kidneys and bladder are functioning properly or they could become very ill or even die. Always make sure that you check their cath bag at the end of your shift. Yes the numbers and lines are pretty small, but do your best to get as close a reading as possible. In order for that number to mean anything, you have to know how much liquid they have had that day. Include ALL things that are liquid or that turn into liquid, such as ice-cream or popsicles. If you have a patient on intake and outtake watch, be sure that you are the one that takes up their meal trays so you can note how much they drank, and do not forget nourishments; they have to be counted as well. Never depend on another aide to tell you how much your patient drank because they may be one of the lazy, “I could care less” aids.