urine monitoring

Question 1

is urine ketone testing recommended?

Answer 1

NO (but better than nothing if blood ketone monitoring unavailable)

• Positive urine ketone readings are found in normal individuals during fasting and in up to 30% of first morning specimens from pregnant women.
• Ketonuria is not a real-time measure of ketonemia.

ketostix uses nitroprusside reagents to measure the weakest ketone, acetone, not the more important betahydroxybutyric acid

Question 2

What can lead to a false positive test for urine ketones

Answer 2

presence of several sulfhydryl drugs, including

captopril.

Question 3

What can lead to a false negative test for urine ketones?

Answer 3

when urine is highly acidic, as with large doses of vitamin C.

Question 4

How often should you test urine ketones (if not able to test blood ketones)?

Answer 4

every 4 hours along with BG
- if ketones remain moderate to large after 2 supplemental doses of insulin or patient is unable to drink fluids /vomiting = emerg visit