Post on 19-Dec-2015
To maintain health, the body must take in a certain
amount of fluid each day
Generally, a healthy person needs to take in from 64 to 96 ounces of fluid per day
Fluid BalanceFluid balance is maintaining equal input and
output -- taking in and eliminating equal amounts of fluids
Intake (Input)Liquids a person drinksSemi-liquid foods
GelatinSoupIce creamPuddingYogurt
(Nurses also figure IV solutions, medications, blood, etc.)
OutputUrineFeces (including diarrhea)Vomitus
(Nurses also figure blood loss, chest tube output, drainage tubes, etc.)
Input -Measurement
Know the sizes of the containers your facility uses
Convert all measurements to milliliters (ml)
Output - MeasurementAlways remember to protect yourself with the
proper PPE
Keep container level on a flat surface while measuring
Prevent splashing or spillingIf splashing is a risk: mask,goggles,& gownAfter emptying contents into the toilet,
rinse container and put it awayRemove gloves and wash hands
The diaper/adult brief trickWeight of 1 US Gallon of water = approx. 8.35 lb
(about 3.79 kg)One ounce of water weighs approx. one ounce.
Common Conversions15 drops = 1 ml = 1 cc1 teaspoon = 5ml = 5 cc1 tablespoon = 15 ml = 15 cc2 tablespoons = 1 oz = 30 ml = 30 cc1 cup = 8 oz = 240 ml = 240 cc1 pint = 16 oz = 500 ml = 500 cc1 quart = 32 oz = 1000 ml = 1000 cc
IntakeBy Mouth: all fluids and foods that are liquid
at room temp.Tube Feeding:
Recorded as oral intake or a special column.Used for patients who are unable to swallow,
the unconscious or comatose.Solution contains all nutrients required by the
body and I s more nourishing than IV feedingsGiven through NG (nasogastric) or G
(gastrostomy) tube
Patient will be in a mid fowlers position during feeding and for 30-60 min following.
Make sure there are no kinks in tubing, caution is used when turning or positioning a patient, give frequent oral hygiene, notify nurse if alarm sounds…solution is not flowing…solution is low or empty
IV (Intravenous)Fluids given into a veinIncludes blood units, plasma, and other
solutions
Irrigation-fluids placed into tubes tat have been inserted into the
body.Any fluid removed after irrigation is not intakeIf nasogastric tube is irrigated with 80 mL of solution
and exact amount is drawn back out, this is not recorded as intake.
However, if 60 mL is drawn back out, 20 mL is recorded as irrigation intake
Measurement Is Responsibility of Nurse or other legally authorized team member. (IV, Irrigation, tube feeding)
Output-refers to all fluids eliminated by patientBowel Movement (BM)
Liquid BM measured and recordedSolid or formed BM is usually noted in remarks
column or described under feces.Nurse assistant may measure/record
EmesisMaterial vomited is measured and recordedColor, type, and other facts are noted in remarksNurse assistant may measure/record
UrineAll urine voided is measured and recordedUrine drained by catheter is measured and
recordedNurse assistant may measure/recordUrine output of less than 30 mL per hour must be
reportedIrrigation
Irrigation or suction drainage is measured and recorded
Drainage included from NG tube, chest tube, other tubes
Type, color, and other facts are noted in remarks column
Excess is recorded as output.
Records must be accurateAll amounts are measured in graduates
Container made of plastic or stainless steelHas calibrations for milliliters/cubic
centimeters and/or ounces on the sideSimilar to a measuring cupGraduate should be held at eye level or placed
on solid surface and viewed at eye level to accurately record amounts
Be careful adding or totalingTotals are for 8-hr and 24-hr
Recording I’s & O’sSome agencies keep record at bedside
Team members not I and O of patientRecord measurements on I and O recordAt times, patients are taught to record I and O
Other agencies keep record in patient chartMeasurements are noted on a sheet of paper
and reported.Nurse, unit sec., or authorized team member
records info on Is and Os.
Give careful instructions for I’s and O’sPatient must inform healthcare worker when
they drink fluidsCan recorded glasses of water or quantity
remaining in a filled pitcher.Assistants must think about fluid intake every
time a glass, cup , or water pitcher is removed from the room.
Amounts must be recorded if a guest brings in fluids.
Females: used a bed pan or specimen hatMales: use a urinalPatients must not place toilet tissue or expel
BMs into bedpan or urine collectorIf patients are given correct instructions,
they can cooperate so accurate records can be maintained.
Standard PrecautionsIncludes Urine, emesis, liquid bowel movements, and
drainage.Gloves must be worn when fluids are measured and
discarded.Hands must be washed frequently and immediately
after removal of glovesIf splashing or spraying of fluids is possible, a mask,
eye protection, and a gown must be wornGraduate must be used for one patient only, and
discarded or sterilized when output is no longer measured.
Areas contaminated by body fluids must be wiped with a disinfectant
Basic principles for completingI and O recordsUse a blue or black ink penFind correct timeFind correct column (oral intake, urine
output)Record correct amountRecheck all entriesEnter observations: color, typesAll information for an 8-hr time period is
recorded, total each column separately to calculate the 8 hr total
When all 8-hr time periods have been totaled, add the 3 8-hr totals for each separate columnThis gives a 24 hr totalSome charts are 24-hr without 8-hr increments
Recheck all additionError: draw one red line through error, initial in
redFinal check:
All entries correct, comments are noted in remarks column, addition is accurate, entries are neat and legible.