PERFORMANCE EVALUATION CHECKLIST

URINALYSIS USING ACETIC ACID

Description:
Urine test Acetic acid is a test that detects the presence of
albumin proteins in the urine.

Purpose:
 To detect the presence of albumin in sample urine (may
indicate PIH in pregnant
woman)

Materials:
1 test tube Test tube holder
10% acetic acid Urine specimen (early morning urine,
midstream flow)
Alcohol lamp Match
Dropper (2 pieces)

Assessment
1 Assess if the collected urine specimen is taken before meals and
midstream flow for more accurate results.
Planning
2 Prepare the place and all the materials needed for the procedure.
Implementation
3 Introduce yourself and explain to the client what you are going to
do and why it is necessary.
4 Place the paper lining on a table or any clean, flat surface from the
client. (clean side out).
5 Place the plastic lining (clean side in) over the paper thing.
6 Place the CHN bag over the plastic lining, tucking the handles
beneath the bag.
7 Open the bag, take out soap in dish, apron and towel.
8 Do thorough hand washing. Dry hands. Put on apron, right side
out. Wear gloves for added protection.
9 Take out the kidney basin and place 3 cotton balls with alcohol.
10 Take out 2 droppers and place them in the kidney basin, same with
the test tube and test tube holder. Take out the match, alcohol
lamp, acetic acid and place them near the kidney basin.
11 Place the waste receptacle at one of the work area.
12 Light the lamp.
13 Fill the test tube about 2/3 full of urine.
 14 Heat the upper portion of the test tube to boiling point.
(Mouth of the tube should not face the examiner and client)
15 Add 5 drops of 10% acetic acid one drop at a time. Heat again.
(Used droppers should be placed near the waste receptacle)

16 Note for changed in color.

Interpretation:
No turbidity: negative
Faint turbidity: (+)1
Moderate turbidity: (+)2
Heavy Turbidity: (+)3
Solid (opaque): (+)4
17 Put off the flame.
18 Wash and drain all the articles used. Discard waste receptacle
19 Do thorough hand washing, dry hands.
20 Return all articles in their proper places in the bag.
21 Remove apron away from the body, folding contaminated part
in place in the pocket of the bag.
22 Fold the plastic lining used top in. Insert in between the bag and its
cover.
23 Close the bag.
24 Document test result.
Evaluation
25 Ensure that you educate your client about the procedure and result.
Total Score:
Transmuted Grade:

PERFORMANCE EVALUATION CHECKLIST

URINALYSIS USING BENEDICT’S SOLUTION

Description:
 Urine test using benedict’s solution is a test to determine the
presence of glucose in urine. Glucose found to be present in urine
is an indication of Diabetes mellitus.

Purpose:
 to detect for the presence of glucose in urine.

Materials:
Benedict’s solution
Test tube
Alcohol lamp
Test tube holder
Droppers (2 pieces)
Urine (Early morning, midstream flow)
Match

1 Assess if the collected urine specimen is taken before

meals and midstream flow for more accurate results.
2 Prepare the place and all the materials needed or for the
procedure.
3 Introduce yourself and explain to the client what you are
going to do and why it is necessary.
4 Place the paper lining on a table or any clean, flat surface
away from the client (clean side out).
5 Spread the plastic lining over the paper lining (clean side in).
6 Place the CHN bag over the plastic lining, tucking the handles
beneath the bag.
7 Open the bag, take out soap in dish, apron and towel.
8 Do thorough hand washing. Dry hands. Put on apron, right
side out. Wear gloves for added protection.
9 Take out the kidney basin and place 3 cotton balls with alcohol.
1 Take out 2 droppers, a test tube and holder, and place them in the
0 kidney basin. Take out the alcohol lamp, match .Benedict’s solution
and place them on the work area.
1 Place the waste receptacle at one corner of the work area.
1
1 Light the lamp.
2
1 Place 6-8 drops of urine in the test tube.
3
1 Add 3-5 ml. of Benedict’s solution to the urine. Used
4 droppers should be placed near the waste receptacle.
1 Hold the test tube with the holder, pass the test tube with
5 mixture over the flame. Mouth of the test tube should be
away from you and the client.
 1 Boil for 2 minutes or keep it in the boiling water bath for 5 minutes.
6

1 Remove from flame and stand for one minute. Put off flame.
7
1 Observe and note for any changes in color
8 Interpretation
Clean blue: negative
Bluish green: (+) 0.5% sugar
Yellowish green: (++) 1% sugar
Orange: (+++) 1.5% sugar
Brick red: (++++) 2% or more sugar
1 Wash and drain all the articles used. Discard waste receptacle
9
2 Do thorough hand washing, dry hands.
0
2 Return all articles in their proper places in the bag.
1

2 Remove apron away from the body, folding contaminated part

2 in place in the pocket of the bag.

2 Fold the plastic lining used top in. Insert in between the bag and its
3 cover. Close the bag.
2 Document test result.
4
Ensure that you educate your client about the procedure
25 and result.