General

Synonym/Acronym:
Ketone bodies, acetoacetate, acetone.

Rationale
To investigate diabetes as the cause of ketoacidosis and monitor therapeutic interventions.

Patient Preparation
There are no food, fluid, activity, or medication restrictions unless by medical direction. As appropriate, provide the required urine collection container and specimen collection instructions.

Normal Findings
(Method: Colorimetric nitroprusside reaction) Negative.

Critical Findings and Potential Interventions

• Strongly positive test results for glucose and ketones.

Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.

Consideration may be given to verification of critical findings before action is taken. Policies vary among facilities and may include requesting immediate recollection and retesting by the laboratory or retesting using a rapid point-of-care testing instrument at the bedside, if available.

An elevated level of ketone bodies is evidenced by fruity-smelling breath, acidosis, ketonuria, and decreased level of consciousness. Administration of insulin and frequent blood glucose measurement may be indicated.