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Intake and output chart

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Here, we discuss about the intake output chart.
The intake output chart is a vital in patient care. By maintaining intake output chart we can monitor the improvement of the patient. So, here we provide about the intake output chart, indications, procedure, precautions, maintaining chart and more.
Please read it attentively and upgrade your professional knowledge and apply it to practice.

Publicada em: Saúde e medicina
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Intake and output chart

  1. 1. Welcome
  2. 2. Intake & Output Chart
  3. 3. Introduction: Water is essential for life and maintaining the correct balance of fluid in the body is crucial to health. Measuring intake and output chart is one of the most basic methods of monitoring a client’s health. Accurate 24 hours measurement and recording is an essential part of patient assessment. In critically ill patent 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 intervention and Subcutaneous fluids.
  4. 4. Definition of Intake: Measurement of all those fluids entering the clients body such as water ,ice chips, juice, milk, coffee, ice-creams and fluid include: Parenteral, central line, feeding tube ,artificial irrigation and blood transfusion.
  5. 5. Definition of Output: Measurement of all fluid level that leaves the clients body such as urine, perspiration, exhalation, diarrhea, vomiting, drainage, bleeding and wounds
  6. 6. Definition of intake and output chart: Measurement of a patient’s fluid intake by mouth, feeding tubes or intravenous catheters. And output from kidneys gastrointestinal tract, drainage tubes , and wounds accurate 24 hours measurement and recording is an essential part of patient assessment.
  7. 7. Body fluid compartments: To make a competent assessment of fluid balance, nurses need to understand the fluid compartments within the body- Compartments Fluid content Intracellular compartment (inside the cell) Intracellular fluid Extra cellular compartment (outside the cell ) Extra cellular fluid Intercellular compartment/ Interstitial space (Between the cell) Interstitial fluid or intercellular fluid. Intravascular compartment ( in blood) Plasma
  8. 8. The purpose of intake and output calculation:  Ensure accurate record keeping.  Prevent circulatory overload  Prevent dehydration  Aids in analyzing trends in fluid status  Contributes to accurate assessment record.
  9. 9. Indication of intake and output chart: Fluid and electrolyte imbalance. Kidney impairment patient’s. In case of dialysis patient’s. Client’s with burns. Recent surgical procedure. Severe vomiting or diarrhea. Taking diuretics or corticosteroids. Congestive heart failure. In case of dehydration.
  10. 10. Decreased or little urine output Dry mucous membrane. Any bleeding. Excessive perspiration. Dark concentrated urine.
  11. 11. Importance of measuring fluid intake and output chart: Physician diagnosis and treatment may depend on accurate measurement of intake and output. Measurement of intake and output can monitor progress of treatment or of a disorder. This provides information about retention or loss of sodium and ability of the kidneys to concentrate or dilute urine in response to Fluid change.
  12. 12. Daily physiological fluid balance: Intake Output o Ingested liquid : 1500 ml o Ingested food : 800 ml o Metabolism : 200 ml o kidney : 1500 ml o Skin loss : 600 ml o GI : 100 ml o Lung : 300 ml Total = 2500ml/day Total = 2500ml/day
  13. 13. Why are Intake and output chart so important Its helps us determine the patient’s fluid status- 1. Are they hydrated? 2. Are they Dehydrated? 3. Are they fluid overload? 4. Is there an obstruction?
  14. 14. Percent of water in the human body:
  15. 15. Measuring fluid intake and output : Intake  Ice chips  Juice  Coffee  Yogurt  Jelly  Intravenous/ Tube feeding  Catheter or tube irrigants Anything liquid at room temperature.
  16. 16. Output : The amount of fluid is eliminated by body: Emesis  Urine  Blood/ Drainage  Liquid stools  NG drainage  Vomiting Watery stool
  17. 17. Significance of measuring Intake and output : • Inform • Required • Explain • Emphasize
  18. 18. Equipment : Intake and output chart:
  19. 19. Cont…… Paper and pencil
  20. 20. Cont……. Calibrated drinking glass
  21. 21. Cont……. Bed side commode
  22. 22. Cont……. Male and female urinal:
  23. 23. Cont…….  Weighting Scale  Calibrated container to measure output  Gloves
  24. 24. Procedure:  Explain the purpose and Procedure for measuring Intake & Output to the Patient.  Record the volume for all fluids consumed. Make sure that all I/V fluids or tube feeding are being administered at the prescribed rate.  Ensure that the nurse who adds additional I/V fluid containers also record the volume  Keep track of fluid volumes used to irrigate drainage tubes or flush feeding tubes. Wear gloves. Measure and record the volume of voided urine, urine collected in catheter drainage bag, liquid stool on other.
  25. 25. Cont…..  Monitor vital sign Wash hand.  Check the volume remaining currently infusing I/V fluid.  Record the total amount of all fluid intake and output volumes.  Compare the data to determine if the intake and output are approximately the same.  Report major difference in Intake & Output to the client’s physician.  Review the plan of care and if the goals have not been met.  Report the Intake & Output volumes Intravenous fluid credit amount and other data.
  26. 26. Documentation:  Date and time  Intake and Output volumes for the next shifts.
  27. 27. Chart: Date Time Name of Drug Urine Suction Signature 05.09.2018 12.00 PM Injection : Cefuroxime 750 mg, IV 300 ml 30 ml Infusion: Normal saline 1000 cc
  28. 28. Complication of patient if intake and output chart is not maintain accurately:  Fluid balance- A. Dehydration: • Fever is present. • There is decrease in urine. • Urine is contracted. • Weight loss occur.
  29. 29. Cont…… • Membrane are dry and it is difficult to swallow. • Tongue is coated thickened. • Skin becomes hard and cracks and is dry and warm. B. Edema: • Decrease in urine output. • Gain in weight. • puffiness or Swelling •Sometimes shortness of breath.
  30. 30. Nursing care plan: Nursing Diagnosis Goal Nursing Intervention Evaluation Deficit fluid volume related to excessive urine output Maintain Adequate fluid balance  Maintain fluid balance.  Electrolyte Imbalance maintain.  Administration Intravenous of fluid.  Additional potassium as prescribed.  Monitor cardiac Manifestations of hypokalamia. Gradually maintain Adequate fluid balance Risk of edema due to excess fluid volume. Maintain Normal fluid volume  Assess the excess fluid volume.  Administer diuretics according to doctor order.  Monitor vital sign.  Record output and urine specific gravity. Gradually maintain fluid volume according to body needs.
  31. 31. Nursing Diagnosis Goal Nursing Intervention Evaluation Deficit Knowledge about intake and output chart. Demonstrated knowledge to the patient about intake and output chart.  Give general knowledge about the procedure and its important.  Teach about normal color of urine.  Teach to take adequate amount of fluid.  Teach the patient to report any sign of dehydration or edema. Patient can demonstrated the knowledge about intake and output chart.
  32. 32. Summery: Assessment of fluid balance requires close observation and monitoring of the patient, recognizing that certain groups of patients such as the elderly and children are at particular risk. Patient assessment must be guided by an understanding of the basic principles of normal physiology and how illness or injury can cause fluid/electrolyte imbalance. Nursing assessment of fluid balance must include knowledge of the history of the patient, careful examination and clinical observation and an understanding of the significance of laboratory data.
  33. 33. Reference: 1. http:// medical-dictionary.thefreedictionary.com/intake+and+output. 2. http://www.nursing times. Net 3. http://www.Medical news today's www.medicalnewstoday.com/...285666 4. http://www.healthline.com 5. http://en.oxforddictionaries.com/definition/intake 6. http://medical-dictionary.thefreedictionary.com/output
  34. 34. Thanks