Ketonuria

Definition

Ketonuria is the excretion of ketone bodies in the urine, indicating that the body is breaking down fat for energy rather than glucose. It is a key finding in diabetic ketoacidosis (DKA), prolonged fasting, and low-carbohydrate diets.

Causes

• Uncontrolled type 1 diabetes / DKA
• Starvation or fasting
• Ketogenic diet
• Hyperemesis gravidarum
• Excessive alcohol intake

Nursing Considerations

In diabetics, test urine ketones when BG is greater than 240 mg/dL, during illness, or when symptoms suggest DKA. Increase fluid intake, administer insulin per protocol, consult provider for persistent or large ketones. Educate about sick-day rules and adequate insulin coverage.

NCLEX Relevance

Urine ketones help detect early DKA.