FUNDAMENTALS OF NURSING

1. Urinary elimination

3.  Elimination is the expulsion of waste products from
the body through the skin ,lungs,kidneys and rectum
 Urinary elimination is the removal of waste products
from the body through the urinary system(urine)

4. Review of physiology of urine elimination
 When the urine is collected in the bladder,desire to void is
experienced due to the stimulation of stretch receptors.
 This sensation occurs when the bladder is filled with 250-450 ml of
urine in adults and 50 -200 ml in children.
 The stretch receptors transmit the message to the voiding reflex
center in the spinal cord(2nd to 4th sacral vertebrae)
 If the time is appropriate the brain seeds message through spinal
cord causing stimulation so that the urine can be released from the
bladder.
 If the time and place are appropriate the external sphincter relaxes
and the urination process takes place.

5. Composition of urine:
 Urine consists of 96% of water and 4% of solids.
 The solids include organic and inorganic substances
 Organic
Urea,uric acid,creatinine,ureates,chlorides,phosphates,sulphates, and
oxalates
 Inorganic:
Sodium,potassium,calcium,chlorides,phosphate,sulfate,oxalates,

6. Characteristics of normal range:
 Volume: An amount of 1000-2000 ml of urine excreted in 24
hour.
 Color:the normal urine is pale yellow or amber in color.when the
quantity of urine is increased,the color becomes pale yellow and
when the quantity of urine decreased,the color becomes deep
yellow
 Appearance:the normal urine is clear with no deposit.
 Odour:the normal urine has an aromatic odour
 Reaction:reaction of normal urine is slightly acidic
 Specific gravity:it varies from 1.016 - 1.025 with a normal fluid
intake.

7. Factors influencing urinary elimination
 Developmental factors:
 Infants:usually amount of voiding is 15 to 60 ml a day after
birth,increasing to 250-500 ml a day.An infant may urinate as often as 20
times a day.it is colorless and odour less and has a specific gravity of
1008.infants are born without urinary control.
 Preschoolers:pre-schoolers is able to take responsibility for independent
toileting.
Enuresis:involuntary passage of urine
Nocturnal enuresis or bed wetting:is the involuntary passing of urine during
sleep.
 School age children:their elimination system reaches maturity
 Older adults: the excretory function of kidneys diminishes with age.due to
decreased kidney’s filtering ability,decreased muscle tone and contractility of
detrusor muscle,decreased reabsorptive and secretory capabilities

8.  Psychological Factors:
Anxiety and emotional stress may cause a sense of urgency
and increased frequency of urination.anxiety can prevent a
person from being able to urinate complety .
Privacy , normal positions,sufficient time can stimulate the
micturition reflex.
 Fluid intake:
If fluid intake is greatly increased,frequency of voiding
increases.if fluid intake is decreased,frequency of voiding
decreases.ingestion of certain fluids directly affects urine
production and excretion .eg:coffee,tea,cola drinks
 Food intake:
Increase urine production and elimination if foods high in
fluid content.eg:fruits,vegetables.

9.  Foods and fluids high is sodium retains water,decrease urine
production and elimination.eg:potato chips,pickles
 Change the color of the urine:eg beetroots cause urine to appear red.
 Body position:
Eg:some men find it difficulty to empty their bladder fully into urinal
while lying flat in bed
 Medications:
Eg:cholinergics,diuretics cause urinary elimination
Anticholinergics,opioid analgesics cause urinary retention
Some medicine cause change in color of urine.eg:
Red—methyldopa
To brown or black-levodopa,ferrous sulphate,ferrous gluconate

10.  Muscle tone and activity:
Regular exercise increases muscle tone and metabolic rate.
Good muscle tone is necessary to maintain stretch and contractility of
muscle tone.
 Pathological conditions:
Some diseases and pathologies can affect the formation and excretion
urine.
Eg:
Diabetic mellitus,multiple sclerosis,Parkinson’s disease –possible loss of
bladder tone.
Benign prostatic hyperplasia-may cause urinary retention and incontinence.
Cognitive impairments such as Alzheimer’s disease-lose the ability to sense
a full bladder or unable to recall the procedure for voiding

12.  Diabetes insipidus:increases urine production
 Neurogenic bladder:the client doesnot perceive bladder
fullness and is unable to control the urinary sphincter.
 Diagnostic procedures:
Eg;Urethra may swell following cystoscopy
Surgical procedures on any part of urinary tract may result in
post-operative bleeding
A restriction in fluid intake commonly lowers urine output.
Surgery of lower abdomen and pelvic structures sometimes
impairs urination because of local trauma to surrounding tissue.

13.  Sociocultural factors:
Certain life-style behaviours can affect urinary elimination by
delaying voiding due to ignoring the urge to void because of:
Insufficient time,unavailability of toilet facilities,lack of
privacy,inability to assume a normal position
Delay in voiding can stretch and weaken the detrusor muscle
lead to incomplete emptying of the bladder,residual urine left in
the bladder and bladder infection:

14. Alterations in urinary elimination;
 1.Polyuria:Production of abnormal large amounts of urine by the
kidney.polyuria can follow excessive fluid intake,a condition known
as polydipsia.
 2.oliguria:Defined as low urine output usually less than 500 ml a day
or 30 ml an hour.
 Diuresis; It is the another term for production and excretion of large
amounts of urine.
 Anuria:refers to a lack of urine production,with no effective urinary
output.
 Nocturia :voiding two or more times at night.
 Dysuria:it means voiding that is either painful or difficult.
 Enuresis:defined as involuntary urination in children.
 Nocturnal enuresis:involuntary urination during night.

15.  Urinary frequency :is voiding at frequent intervals,that is more
than 4 to 6 times per day
 Urgency :is the sudden ,strong desire to void.

16. Urinary incontinence
 UI is the involuntary passage of urine.
 It refers to the inability to control passage of urine.
 It is a symptom.not a disease.
 It may be temporary or permanent.
 Leakage may be continuous or intermittent.
 Causes:
 UTI,Surgery,trauma causing sphincter damage, STDs,paralysis,leakage
when coughing,sneezing due to increased abdominal pressure,fecal
impaction,old age,cognitive impairment,unconsciousness

17. Types of incontinence and clinical
manifestations
 Stress incontinence:
Involuntary loss of urine through an intact urethra as a result of sudden
increase in intra abdominal pressure.
It is seen mainly in women who have had vaginal deliveries
 Urge incontinence:
Involuntary loss of urine associated with a strong urge to void that cannot
be suppressed.
 Reflex incontinence:
Involuntary loss of urine due to hyper reflexia in the absence of normal
sensation .
 Overflow incontinence(functional incontinence)
It is the involuntary loss of urine associated with over distention of the
bladder
.

18. Measures to reduce the problem of
incontinence:
 Establish a regular voiding schedule for the patient.
 Perineal exercises: these increases the tone of muscles concerned with
the micturition, in particular the perineal and abdominal muscles. Periodic
tightening of the perineal muscles, intentionally stopping and then
starting the urine stream etc. Can help in gaining voiding control.
 Arrange toilet or bedpan within the easy reach of the patient .
 Medical and surgical correction of the causative factors.
 bladder training program ;
Includes:education of the client and support people
Bladder training: which requires that the client postpone voiding,resist or
inhibit the sensation of urgency and void according to a timetable rather
than according to the urge to void.the goal are to gradually lengthen the
Interval between urination,to stabilize the bladder and to diminish urgency

19. Habit training;(timed voiding or scheduled
toileting) attempts to keep client dry by having
them void at regular intervals
Skin care:
Condom drainage

20. Urinary retention:
 The state in which one experiences incomplete emptying of the
bladder.
 When the emptying of bladder is impaired,urine accumulates and
the bladder becomes over distended.
 Over distention of the bladder causes poor contractility of detrusor
muscle further impairing urination.
 Cause:
 Obstruction of urine flow:( prostate gland
enlargement,pregnancy,urethral edema,surgery or diagnostic
examinations
 Alteration in motor or sensory innervation to the detrusor muscle and
internal sphincter.eg:spinal cord injury,peripheral nerve
trauma,degeneration of peripheral nerves
 Inability to relax external spinchter:(emotional stress or anxiety ,muscle
tension

21. Prevention and treatment of retention
of urine;
 Methods used in inducing natural urination are:
 Assist the patient to his or her normal position for voiding.
 Provide privacy.
 Offer a bedpan or urinal that is warm.a bedpan that is cold to
touch may cause contraction of the perineal muscles
 Foster the muscles relaxation by providing necessary physical
support to the patient and by relieving pain.
 Provide any assistance when the patient feels the need to void

22.  Micturition is a conditioned response.running water within the
hearing of the patient or flushing the toilet stimulate the
micturition reflex.
 Provide enough time for micturition.
 Reassurance and emotional support are helpful to reflex the
patient
 A hot enema,if permitted may relieve the retention of the
urine.
 Give fluids freely unless contra-indicated.
 When all these nursing interventions failed,catheterisation of
the bladder is done with the doctor’s permission.
 Certain drugs which cause contraction of the bladder may be
ordered by the doctor

23. specimen types:
 Random specimen:
A randomly collected specimen collected at unspecified
times and is often more convenient for the patient
 First morning specimen or 8 hour specimen:
 Fasting specimen:
 2-hour postprandial specimen.
 24 hour (timed) specimen.
 Catheterized specimen

24.  Midstream clean catch specimen:
 Suprapubic aspiration:
 Pediatric specimen

25. Collection of urine specimen:
 Urine collection by U-Bag for infants
 Urine collection from catheter
 24 hours urine collection
 Collection of mid stream urine

29. Providing urinal ;
 Meeting urinary elimination need of bed-ridden male patients using
an urinal
 Purpose:
 To meet and maintain the elimination needs of the client
 To give perineal care
 To observe and collect specimen for diagnostic procedure.
 Procedure:
 Assess patient’s normal urinary elimination habits
 Palpate for distended bladder
 Assess patient knowledge regarding urinal use.
 Wash and don gloves
 Provide privacy
 Assist patient into appropriate position

31.  Patient should hold urinal and position penis in urinal.
 Once patient has finished voiding,remove urinal.
 Collect urine in container if required and empty urine into
toilet
 Cleanse the urinal.
 Allow patient to wash hand and penis after voiding.
 Remove gloves and wash hands
 Record and report patient’s ability to use urinal,output and
characteristic of urine. Record amount of urine passed if
needed.

32. Providing bedpan:
 Offering a bedpan to meet the elimination need of a bed-
ridden patient
 Types:regular and fracture bedpan
 Purpose:
To facilitate bowel and bladder elimination in a bedridden patient
To collect specimen
To give perineal wash
To perform bowel and bladder training.

34.  Disposable gloves
 Clean bedpan with lid.
 Draw sheet
 Soap
 Warm water in jug
 Mackintosh
 Specimen container

35.  Assess patient’s bowel elimination habits, routine pattern, effect
of certain foods on bowel elimination and normal fluid intake.
 Assess patient’s level of mobility, amount of assistance
required and positions that the patient can assume.
 Assess for abdominal pain,haemorrhoids,irritation of skin
surrounding anus.
 Wash hands and don gloves
 Provide privacy
 Warm bedpan under warm running water
 Position bed to convenient height.
 Elevate side rails on opposite side.

36.  In patients who can move lower limbs,ask patients to flex
knees,resting weight on back or legs,and then raising the buttocks.
 Position patient to side lying position,place bedpan against
buttocks and roll patient onto bedpan back to supine position.
 Elevate patient’s bed to a semi fowler’s position or support patient’s
back with pillows
 Cover patient with bed linen and permit patient to be alone with
call bell within reach,elevate side rails.

37.  When removing bedpan ,hold bedpan steady,remove it,cover it
and place it away
 If patient can help himself,provide perineal and analcare
 Provide soap and water for the patient to clean his hands and dry
hands thoroughly.
 Send bedpan to sluice room
 Remove gloves and wash hands
 Position patient comfortably and change linen if wet
 Record the procedure

38. Condom drainage
 Condom :it is a soft ,pliable rubber shealth applied over the
male’s penis.
 Purpose:
To drain urine in incontinence and unconscious patients
who have complete and spontaneous bladder emptying.
Equipment:a tray containing
Condom,adhesive tape ,urinecollectionbag with drainage
tubing,basin of warm water and soap,towel and wash
clothes,cover sheet,protective sheet

39.  Explain procedure to patient and assess status of patient
 Wash hands
 Provide privacy.
 Assist patient to supine position
 Assess condition of penis
 ‘apply disposable gloves.provide perineal care and dry thoroughly.
 Prepare urinary collection bag and tubing
 Apply skin preparation to penis
 With non-dominant hand,grasp penis along shaft and with dominant hand roll
condom sheath onto penis
 Allow 2.5 to 5 cm of space between root of penis and end of condom catheter
 Encircle penile shaft with a strip of elastic adhesive
 Connect drainage tubing to end of condom catheter.
 Place patient in safe and comfortable position
 Remove gloves. Dispose off contaminated supplies and wash hands

40.  Return in 30-60 mins to observe for urinary drainage.
 Record.

43.  Guidelines:
 When securing the condom,be sure that
Adhesive band is not tight and it touches only the condom
 Condom and drainage tubes are changed on alternate days
 When changing condom,clean the urethral meatus and penis
thoroughly and check for signs of skin infections
 Check the tubing frequently for patency
 Check the twisting of the condom near drainage tubing causing
irritation and obstruction of urine outflow.

44. Catheterisation of the urinary bladder:
 Uc is the introduction of a tube(a catheter) through the urethra into the
urinary bladder to drain the bladder.
 Purpose:
 To get a sterile urine specimen for diagnostic purposes
 To empty the bladder when a condition of retention is thought to exist
 To measure the amount of residual urine when bladder is incompletely
emptied.
 To empty the bladder prior to surgery involving rectum,vagina, and pelvic
organs.
 To prevent urine passing over a wound
 To provide for intermittent or continuous bladder drainage and irrigation
 To manage incontinence

45. Principles:
 Microorganisms are present in the environment on the articles
and skin. Pathogenic organisms are transmitted from the source
to a new host directly or by contaminated articles.
 Cleaning an area where there is less number of organisms,
before cleaning an area where there are more organisms,
minimise the spread of organisms to the clean area.
 Urinary bladder is a sterile cavity and the urinary meatus
act as a portal of entry for pathogenic organisms.
 A break in the integrity of the skin and mucus membrane
provides ready entrance for microorganisms. Skin and mucus
membranes can be injured by chemical,mechanical,thermal, and
microbial agents.

46.  Lubrication reduces friction
 Thorough knowledge of anatomy and physiology of the
genitourinary system facilitates catheterisation of the
urinary bladder
 Systematic ways of doing saves time,energy, and material
 Any unfamiliar situations produce anxiety

47. Indications
 Acute or chronic retention of urine
 Comatosed petients,neurogenic bladder,hypotonic bladder,spinalcord injury
 Incontinence of urine
 Before surgical intervention of pelvic organs
 Investigation purpose.
 Types:
 Intermittent :single straight use catheter is introducing for a period long
enough to drain the bladder. When the bladder is empty ,the nurse
immediately withdraws the catheter .it can be repeated as necessary
 Indwelling or foley’s catheter:it remains in place for an extended period
until a client is able to void completely and voluntarily.
 Children usually require :no.8 or 10 French
 Women requires no 14 to 16
 Men no 16 to 18

51. General instructions:
 Avoid catheterisation unless ordered
 Observe strict aseptic techniques
 Never use force
 Always catheterise in a good light
 Clean the perineum from pubis downwards to the anal region
 Clean the urinary meatus and the area around with a disinfectant using
downward movements.
 Use one cotton ball for one swabbing.
 Don’t touch the portion of the catheter that is going into the urinary
tract.
 Lubricate the catheter well before introducing into the urinary tract.
 Keep the patient relaxed by providing privacy and explaining the
sequence of the procedure

52. After care of the patient and articles:
 Wash hands and dry the perineum
 Remove the drape sheet and replace the bed linen
 Position the patient in correct alignment
 Measure urine and observe the characteristics of urine and
record it
 Wash the articles and replace in utility room
 Send the urine specimen for laboratory investigation
 Maintain an intake –output chart
 For indwelling catheter ensure complete closed urinary
drainage system.empty the collection bag,atleast 8
hours.keep tubings free of kinks

53.  Remove foley’s catheter by first completely deflating the ballon
 Perineal exercise help restore sphincter control after a
catheter is removed.
 Complications
 Urinary tract infection
 Allergic reaction to the material used in the catheter such as
latex
 Hematuria
 Tissue trauma during the insertion of the catheter.

54. Bladder irrigation:
 It is the washing out of the bladder, by directing a stream of
solution into the bladder, through the urinary meatus by means of
the catheter.
 Purpose:
To ensure patency of the urinary drainage system
To cleanse the bladder from stagnant urine,bacteria,excess mucus,pus and
blood clot
To relieve congestion and pain in inflammatory condition
To promote healing
To medicate the lining of bladder
To arrest bleeding
To prepare the bladder for surgery as a pre-operative measure

55.  Types of irrigation :
 Open method:it is done with an asepto syringe in which
is introduced into the urinary bladder and drained out
simultaneously
 Closed method:this provides for frequent intermittent or
continuous irrigation without disruption of the sterile catheter
system.
 Solution used:
 Distilled water,normal saline,sodium nitrate(1:8000),boric acid
2%,potassium permanganate (1:10000),acriflavin I in1000, silver
nitrate1 in 5000,acetic acid 1n 400.

57. Perineal care:
 Perineal care is the care of perineum which involves cleaning
of the external genitalia and the surrounding area .
 Purpose:
To remove normal perineal secretions and odour.
To promote client comfort.
Indications:
Client,who are unable to do self care to maintain perineal
hygiene,genitourinary tract infection,incontinence,indwelling
catheter,postpartum clients,any surgery,ulcer or injury on the
perineal area.

58.  Explain the procedure
 Provide privacy
 Remove all articles that may interfere with the procedure.
 Offer bedpan
 Wash hands
 Pour waterantiseptic solution over the perineum.
 Clean the perineum using the wet swabs
 Hold the swabs with forceps and clean from above down to anal orifice.
 Use one swab for one swabbing
 Clean the perineum from the midline outward in the following order
 The vulva,labia minora both sides,labia majora both sides,thighs
 Clean the anus thoroughly
 Remove bedpan by supporting hips.turn the patient to one side and dry
buttocks with dry gauze pieces

59.  After care
 Apply the medicine and pad if necessary
 Remove the mackintosh and drape sheet
 Change the linen if necessary
 Make patient comfortable,
 Take the bedpan to the sanitary annex
 Clean all the articles
 Wash hands
 Record the procedure.

60. Nursing management:
 Assessment:
 Nursing history: client's normal voiding pattern,frequency,appearance
of urine, any recent changes,any past or current problems with
urination,presence of ostomy,factors influencing the elimination
pattern.
 Physical assessment:
 Palpation of kidneys to detect areas of tenderness,palpation and
percussion of the bladder,urethral meatus inspected for
swelling,discharge,inflammation.
 Skin of perineum should be inspected for irritation
 Assessing urine

61.  Measure urinary output.
 Measuring residual urine.
 Diagnostic tests
 Nursing diagnosis;
 Impaired urinary elimination related to (anatomic obstruction,
sensory motor impairment, urinary tract infection
 Functional urinary incontinence related to (alteration in
cognitive functioning, neuromuscular impairement,psychological
impairement)
 Urinary retention related to(blockage in urinary tract, strong
sphincter, high urethral pressure.
 Risk for infection related to (catherisation)

62. Planning :
 Maintain or restore a normal voiding pattern
 Regain normal urine output
 Prevent associated risks
 Perform toileting activites independently with or without
assistive devices

63. implementing
 Maintaining normal urinary elimination:
 Promoting fluid intake.:increasing fluid intake increases urine
production,which in turn stimulates the micturition reflex.A normal daily
intake averaging 1500 ml of measurable fluids is adequate for most
adult clients.
 Maintaining normal voiding habits.(bladder training)
 Preventing urinary tract infection;(drinking plenty of water,frequent
voiding,avoiding use of irritating soaps,powder,sprays,avoiding tight
fitting pants,wearing cotton undercloths,
 Managing urinary incontinence:bladder training,pelvic muscle
exercises(kegel exercise),maintaining skin integrity,applying external
urinary draining devices

64.  Managing urinary retention:(catheterisation,
 Nursing intervention for clients with indwelling catheters:
Encourging large amount of fluid intake,
Dietary measures: acidifying the urine of clients with
retention catheter reduce the risk of UTI and calculus
formation.(foods such as eggs,meat,tomatos,plums etc)
Perineal care:
Changing the catheter and tubing

65. Supra pubic catheter care
 A Suprapubic catheter is inserted surgically through the
abdominal wall above the symphysis pubis into the
urinary bladder.
 Care of clients with a suprapubic catheter includes
regular assessment of the client’s urine,fluid
intake,maintenance of a patent drainage system,skin care
around the insertion site ,periodic clamping of the
catheter preparatory to removing it if it is not a
permanent appliance.

67. Care of urinary diversion:
A urinary diversion is the surgical rerouting of urine
from the kidneys to a site other than the bladder.it is
usually created when the bladder must be removed.

68. 2 Categories of diversions;
 Incontinent;Clients have no control over the passage of urine and
urine drains through a hole in the abdomen into a bag.
Eg:Ureterostomy,nephrostomy,vesicostomy, and illeal conduits
 Ureterostomy:one or both of the ureters may be brought directly to the
side of abdomen to form small stomas.
 Nephrostomy:diverts urine from the kidney to a stoma
 Vesicostomy:it is formed when the bladder is left intact but voiding
through the urethra is not possible.the ureters remain connected to the
bladder and the the bladder wall is surgically attached to an opening
in the skin below the naval,forming an incontinent stoma.
 Ileal conduit or ileal loop: a segment of the ileum is removed and the
intestinal ends are reattached.one end of the portion removed is closed
with sutures to create a pouch,and the other end is brought out
through the abdominal wall to create stoma.the ureters are implanted
into the ileal pouch

71.  Continent diversions:in this ,creation of a mechanism that allows
the client to control the passage of urine,either by intermittent
catheterization of the internal reservoir or by strained voiding.
 Eg:kock pouch;(continent ileal bladder conduit ,uses a portion of
to form a reservoir for urine.here nipple valves are formed by
doubling the tissue backward into the reservoir where the pouch
connects to the skin and ureters connect to the pouch.these valves
close as the pouch fills with urine.,preventing leakage and reflux of
urine back towards the kidneys.the client empties the pouch by
inserting a clean catheter approximately every 4 hours.
 Neobladder: replaces a diseased or damaged bladder with a piece
ileum.this new bladder is then sutured to the functional urethra to
facilitate client voiding control

74. Care of urinary diversion
 Assess intake and output.
 Changes in the urine color ,odor,clarity,
 Assess the condition of stoma
 Monitor serum electrolyte values,acid base balance,renal
function tests.etc
 Teach the client regarding skin care ,increased fluid
intake,self catheterization.signs of infections.

76. Urine analysisurine testing
 Urine testing refers to laboratory analysis on a routine
or clean voided specimen or a specimen obtained from
the catheter to perform a routine or microscopic
examination of urine.

77. purposes
 To observe urine colour and clarity
 To measure urine specific gravity
 To determine the acidity and alkalinity of urine
 To determine the presence of glucose,albumin,ketone
bodies in urine
 To aid in diagnosis of renal disorders(acute renal
failure,chronic renal failure etc)
 To carry out the microscopic examination of urine after
centrifuging for the detection of red blood cells,occult
blood,pus,crystals,bacteria

78. Indications
 Renal disease(acute renal failure ,acute glomerulo
nephritis)
 Metabolic disorders(hypercalcemia,hypokalemia)
 Patient receiving nephritic drugs
 Cystitis, urinary tract infection
 Diabetic patients
 Congestive cardiac failure.
 Dehydration

79. test Steps of procedure rationale
Urinary pH Dip one end of the blue litmus paper into
urine.observe changes in color of blue litmus
paper
Blue litmus paper remains blue if
urine is alkaline.or red if urine is
acidic(it is the measurement of
concentration of H+ in urine)
Specific gravity Pour 20 ml of fresh urine sample in the glass
cyclinder or fill the cyclinder 3 quarters full.
Place the urinometer into the cyclinder.allow the
urinometer to flow in urine freely
The urinometer should not touch the bottom
and side of the jar.
Hold the urinometer at eyelevel and read the
measurement at the base of meniscus
To determine the client’s
status from the specific gravity.c
Concentrated urine has higher
specific gravity
glucose 1.Benedict’s test
2. Fehling's test
Take an equal quantity of fehling’s solution A
and B into 2 test tubes.,pour together and boil.
In another test tube,take an amount of urine
equal to boiled mixture of F.Solution A AND
B.pour urine into the boiled mixture and
boil.formation of typical red or golden yellow
To determine the presence of
glucose in urine

80. Acetone rothera’s test Take 2 cc of urine in the test tube and
saturate it with ammonium sulphate.
Put a few drops of freshly prepared
nitroprusside.
Add half cc concentrated ammonia,allow it to
stand.dont shake.
If acetone present,a permanent purple
coloured ring is formed at the junction of
urine and ammonia
To determine the
ketone bodies in
urine.ketones are
the end products
of breakdown of
fattyacid
Albumin test: Hot test
Cold test
Pour 2 cc of conc.nitric acid in a test tube
Pour 2cc of filtered urine in another
testtube
With a pipette pour the urine gently along
the sides of the first test tube.
A white ring is at the junction of 2 fluids
indicates the presence of albumin
To determine the
presence of
albumin in the
urine

81. Test for bile 1.Take half test tube of urine and
shake it vigorously.if bile is present,the
froth will be yellow or greenish
2.hey’s test
Take urine in a test tube and sprinkle
sulphur powder on top of it.if bile
present,the sulphur sinks in the
bottom.
3.Iodine test;
Take one third of urine
Add 2 drops of 10% solution of
tincture iodine.if bile is present,a green
color will be obtained at the junction
of 2 liquids