FLUId
management
Richard C Burca, RN,
MSNc
Introduction
Fluid Management in the
body is essential as it allows
the metabolic activities of the
body to function in a normal
manner. It also maintains the
body temperature, delivery of
nutrients to cells, removes
the wastes from the body,
provides acid and base
balance, in a normal body or
Introduction
Water is essential for life and
maintaining the correct
balance of fluid in the body
is crucial to health.
Measuring intake and output
is one of the basic methods
of monitoring a client’s
health. Accurate 24 hour
measurement and recording
is an essential part of patient
Introduction
In critically ill patient, it
becomes very important to
accurately record fluid intake
and output for proper
evaluation and control of
fluid balance. Accuracy in
recording fluid intake and
output is vital to the overall
management of certain
patient groups and facilitate
correct prescribing of
INTAKE OUTPUT
Measureme • Measureme
nt of all nt of all
those fluids fluid that
entering the leaves the
client’s client body
INTAKE OUTPUT
• Oral fluids • Urine
• Ice chips • Vomitus and liquid
• Yogurt feces
• jelly • Tube drainage
• Foods that are tend to • Wound drainage and
become liquid at room draining fistulas
temperature • bleeding
• Tube feedings
• Parenteral fluids
• Intravenous
medications
• Catheter or tube
IMPORTANCE OF I&O
• Provides the means to determine the
progress of the disease and the
beneficial as well as detrimental
effects of treatment
• Help care givers ensure that the
patient has proper intake of fluid and
other nutrients
• Determine whether there is adequate
output of urine as well as normal
defecation
• Provides information about retention
PURPOSE OF i&O
• Ensure accurate record keeping
• Prevent circulatory overload
• Prevent dehydration
• Aids in analyzing trends in fluid
status
• Contributes to accurate assessment
Indication of i&O
• Fluid and electrolyte • Decreased or little urine
imbalances output
• Kidney impairment patients • Dry mucous membranes
• In case of dialysis patients • Any bleeding
• Clients with burns • Excessive perspiration
• Recent surgical procedure • Dark concentrated urine
• Severe vomiting or diarrhea
• Taking diuretics or
corticosteroids
The metric system is used for fluid measurement. The measurements
should be recorded in ml (Milliliter)
The average adult The average adult
intake is 2500- output is 2500-
3000 mL per day 3000 mL per day
Common metric conversion
• 1 tbsp = 15 mL
• 1 tsp = 5 mL
• 1 mL = 1 cc
• 1 ounce (oz) = 30 mL
• 1 cup = 8 oz, 240 mL
• 1 pint = 2 cups
Convert to mL
1. 4 cc
2. ½ pint of milk
3. 2 glasses of orange juice
4. 5 cups pf coffee
5. 6 oz of water
6. ½ cup of milk
7. 8 oz of energy drink
8. 2 glasses of ice chips
•
DO
Identify whether your patient has undergone
surgery or if he has a medical condition or
takes medication that can affect fluid intake
or loss
• Measure and record all intake and output. If
you delegate this task, make sure you know
the totals and the fluid sources
• At least every 8 hours, record the type and
amount of all fluids he’s received and
•
DO
Record the type and amount of all fluids the
patient has lost and the route. Describe them
as urine, liquid stool, vomitus, tube drainage
and any fluid aspirates from a body cavity.
• Measure drainage in a calibrated container
and Observe it eye level.
• Evaluate patterns and values outside the
normal range, keeping in mind the typical
24-hour intake and output
•
DO
When looking at 8 hour urine output, ask
how many times the patient voided to
identify problems
• Regard intake and output holistically
because age, diagnosis, medical problem,
and type of surgical procedure can affect the
amounts. Evaluate trends over 24-48 hours
•
Don’t’s
Don’t delegate the task of recording intake
and output until you’re sure the person
who’s going to do it understands its
importance.
• Don’t assess output by amount only.
Consider color, color changes, and odor too.
• Don’t use the same graduated container for
more than one patient
Don’t’s
Don’t’s
Questions?
