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MEASURING INTAKE AND OUTPUT The measurement and recording of all fluid intake and output during a 24hrs

s period which provides important data about the clients fluids and electrolyte balance. One of the most basic methods of monitoring a clients health, commonly called I/O. PURPOSES For comparison from normal intake and output Helps evaluate clients fluid and electrolyte balance Suggest various diagnosis Influence the choice of fluid therapy Document the clients ability to tolerate oral fluids Recognize significant fluid loss To ensure effective hydration and elimination Measuring Intake and Output is mandatory for clients with the following problems: Burns Electrolyte Imbalance Recent surgical procedure Severe vomiting or diarrhea Taking diuretics or corticosteroids Renal failure CHF NGT, drainage collection device and IV therapy NURSING INTERVENTION -To obtain accurate record -In critical situation I/O should be monitored hourly urine output less than 500ml/24hrs or less than 30ml/hr indicate renal failure -Daily weights are often done indicate fluid retention -Identify if patient undergone surgery or with medical problem -Make sure you know the total amount and fluid sources once you delegate this task to get an accurate measurement - Record the type and amount of all fluid and describe the route at least every 8hrs - Subtract the total amount of irrigating solution, NGT or tube on bladder to get exact amount of output - Keep toilet paper out of your patient urine and measure drainage in a calibrated container. Read the meniscus on eye level PROCEDURE FOR MEASURING INTAKE AND OUTPUT Assessment 1. Check doctors orders. 2. Review the patients status. 3. Establish patients ability to participate. 4. Locate I/O sheet. 5. Decide extent to which patient may participate. Implementation 6. Explain reasons for I/O to patient. 7. Encourage the patient to participate. 8. After meals, record I/O. 9. Add free water taken. 10. Add between-meal nourishment. 11. Each time patient voids, accurately measure amount of urine. 12. Record output on I/O worksheet, using proper column. 13. On parenteral fluids sheet, record any intravenous fluids. 14. On permanent record in chart, fill in totals. 15. Add any other output other than urinary totals. 16. Note any profuse diaphoresis. 17. Total all 8hrs measurements at the end of your shift. 18. Compare intake and output. 19. Compare I/O to norms for patient.

Planning

Evaluation

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