Allied Health & Medicine **Begin Class by reading Ch. 21:5 in Red Book.

Intake and OutputAllied Health & Medicine

**Begin Class by reading Ch. 21:5 in Red Book

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

Fluid volume excessa surplus, an amount greater than that which

is normal or that which is required

Fluid volume deficit a reduction in body fluids – “dehydration”

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

Specimen HatUrinalGraduateTraditional bed panFracture bed pan

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.