Intake Output Chart Guidelines

Outline Definition of intake and output calculation . The purposes of intake and output calculation. The procedure :

1. Equipment .2. Assessment .3. Implementations .4. Documentation .

Negative and positive balance . Situations .

Objectives 1. List the purposes of intake and output

calculations .2. Mentions the parameters of assessments

before intake and output calculation .3. Describe the negative and positive balance.4. Determine who to calculate the intake and

output .

The purposes of intake and output calculation

1. Ensure accurate record keeping.2. Prevent circulatory overloud.3. Prevent dehydration. 4. Aids in analyzing trends in fluid status. 5. Contributes to accurate assessment record.

Why are I/O so Important??

It helps us determine the patient’s fluid status:

Are they Hydrated? Are they Dehydrated? Are they in Fluid Overload? Is there an obstruction?

What To Look Out For• Is the patient drinking at least 1500cc a

day (Unless they are on Fluid Restrictions)• Urinates at least once in an 8 hour shift or

urinate less than 30 cc an hour (240cc/8hrs)

• Has concentrated or foul-smelling urine• Has Dry Skin• Has a temperature above 38⁰C• Is perspiring excessively• Has excessive wound drainage

Possible Causes of Fluid Excess

• Kidney Disease• Liver Disease• Certain Medications : Steroids or a

Sodium Based Medication• Abnormal Fluid Accumulation in Body

Cavities• Over infusion of IV Fluids• Pregnancy

The Procedure The Equipment :Intake and output chart.

Implementations

1. Explain the purpose and procedures for measuring I&O to the client.

2. Record the volume for all fluids consumed.3. Make sure that all IV fluids or tube feedings are

being administered at the prescribed rate.

Cont Implementations 4. Ensure that the nurse who adds additional IV fluid

containers also records the volume .5. Keep track of fluid volumes used to irrigate

drainage tubes or flush feeding tubes.6. Wear gloves. 7. Measure and record the volume of voided urine,

urine collected in a catheter drainage bag, liquid stool or other.

8. Wash hands .9. Check the volume remaining in currently infusing IV

fluids.

Cont Implemenations10.Record the total amount of all fluid intake and output volumes.

11.Compare the data to determine if the intake and output are approximately the same.

11.Report major differences in I&O to the client’s physician.

13.Review the plan of care and if the goals have not been met.

14.Report the I&O volumes IV fluid credit amount, and or other data.

Documentation 1. Date and time. 2. Intake and output volumes for the next shift.

Negative and positive balance: If the total intake for the shift > the total

output for the shift negative balance . If the total intake for the shift the total

output for the shift positive balance .