Measuring Intake & OutputNATCEP Days Twenty Four

Objectives• Identify what is meant by fluid balance, fluid

imbalance and effects of aging on fluid balance

• Identify what is meant by the terms I&O, force fluids, restrict fluids, and NPO

• Identify the reasons for measuring intake and output

• Identify the procedure for measuring and recording fluid intake

• Discuss and demonstrate the procedure for measuring and reporting output

What is Fluid Balance?• The body equalizes the amount of

fluid taken in with the amount of fluid excreted via urination, feces, perspiration and/or breathing

What is Fluid Imbalance?• Too much fluid retained/kept in body

tissue (edema – swelling)• Too much fluid lost (dehydration)

from vomiting, diarrhea, poor fluid intake, bleeding, excess perspiration and increased urine production

Effect of Aging on Fluid Balance

• Swallowing difficulties may cause inadequate intake of fluids

• Physiologial disorders may cause retention of too much fluid

• Imbalances occur more quickly in the elderly• Thirst mechanisms may be impaired

Daily Adult Requirements• 1500 ml/cc of water required to

survive• 2000 – 2500 ml of fluid are needed

for normal fluid balance

Why Measure I & O

• Diagnosis and treatment • Monitor progress of treatment of a disorder

(i.e., effects of a diuretic or kidney disease)• Daily weights are also routinely ordered in

conjunction with I&O

Measuring Intake• Measurement is cc (cubic centimeter) or ml

(mililiters)• All fluids observed and measured per facility

policy• Include foods that are liquid at body

temperature• Totaled at end of shift and at the end of 24

hours

Liquid Foods• Jello• Clear broth/strained soups• Hard candy• Popsicles• Custard/Eggnog• Ice Cream/Sherbets/Milkshakes• Cooked cereals• Pudding• Yogurt

Measuring Output

• Follow standard/universal precautions• All urine and emesis should be measured• Residents must void into a container (bedpan/hat)• Poured into a graduated container so it can be

measured• Measure urine from a catheter by emptying the

bag into a graduate pitcher and then measuring. • Incontinent = record number of times it occurs• All liquid stool should also be measured • Totaled at the end of each shift and at the end

of 24 hours