Checking Ketones

Table of Contents

A child may require their urine to be checked for ketones. Ketones can be caused by chronic health conditions, missed doses of insulin, not enough insulin, a bad or failed pump site, missed long-acting insulin, illness, or going long periods without eating or not eating carbohydrates.  The instructional steps assist the registered nurse working under the auspices of the school or program in professional judgement and accountability of delegation. Additional steps may be required depending on the learner’s health needs.

Steps

  1. Position the student to provide as much privacy as possible.
  2. Explain the procedure to the student at their level of understanding.
  3. Encourage the student to assist in the procedure as much as they are able to help, to foster the student to learn self-care skills.
  4. Gather supplies and place them on a clean surface.
  5. Check the expiration date on testing strips.
  6. Ensure strips are contained in a tightly sealed container and show no signs of discoloration.
  7. Discolored test strips should be discarded.
  8. Wash your hands. Have or help the student wash their hands.
  9. Put on gloves.
  10. Have the student go to the bathroom and provide a urine sample in a urine cup or clean container.
  11. Place the test strip in the urine.
  12. Gently shake excess urine off the strip.
  13. Wait for the strip pad to change color.
    1. The directions will tell you how long to wait.
    2. Be sure to follow timing instructions accurately, as reading too soon or waiting too long could result in inaccurate results.
  14. Compare the strip pad to the color chart on the strip bottle.
    1. This gives you a range of the amount of ketones in the student’s urine.
  15. Discard the testing strip and urine, per school policy.
  16. Remove gloves
  17. Wash your hands. Have or help the student wash their hands.
  18. Document the date, time, procedure completed, and ketone results, student’s response to the procedure, your initials and signature, and any communication with the school nurse or parents in the student’s healthcare record.
  19. Follow any additional steps as instructed by the delegating school nurse.