A nurse must measure the intake and output (I&O) for a patient who has a urinary retention catheter. Which equipment is most appropriate to use to accurately measure urine output from a urinary retention catheter?
A. Urinal
B. Graduate
C. Large syringe
D. Urine collection bag
Correct Answer: B. Graduate
A graduate is a collection container with volume markings usually at 25 mL increments that promote accurate measurements of urine volume. To measure urine output in critical care units, a Foley catheter is introduced through the patient’s urethra until it reaches his/her bladder. The other end of the catheter is connected to a graduated container that collects the urine.
Option A: Although urinals have volume markings on the side, usually they occur in 100 mL increments that do not promote accurate measurements. Urine output is the best indicator of the state of the patient’s kidneys. If the kidneys are producing an adequate amount of urine it means that they are well perfused and oxygenated. Otherwise, it is a sign that the patient is suffering from some complications.
Option C: Large syringe is impractical. A large syringe is used to obtain a sterile specimen from a retention catheter (Foley catheter). Urine output is required for calculating the patient’s water balance, which is essential in the treatment of burn patients. Finally, it is also used in multiple therapy protocols to check whether the patient reacts properly to treatment
Option D: A urine collection bag is flexible and balloons outward as urine collects. In addition, the volume markings are at 100 mL increments that do not promote accurate measurements. In critical care units of first world countries, measurements of every patient’s urine output are taken hourly, 24 times a day, 365 days a year. In the case of emerging countries, often only burn patients—for whom urine output monitoring is of paramount importance—have this parameter recorded every hour, while the remaining critical patients have it recorded every 2 or 3 hours.