Allied Health amp Medicine Begin Class by reading Ch 215 in Red Book To maintain health the body must take in a certain amount of fluid each day Generally a healthy person needs to take in from 64 to 96 ounces of fluid per day ID: 172252
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Slide1
Intake and Output
Allied Health & Medicine**Begin Class by reading Ch. 21:5 in Red BookSlide2
To maintain health,
the body must take in a certain amount of fluid each day
Generally, a healthy person needs to take in from 64 to 96 ounces of fluid per daySlide3
Fluid Balance
Fluid balance is maintaining equal input and output -- taking in and eliminating equal amounts of fluidsSlide4
Fluid volume excess
a surplus, an amount greater than that which is normal or that which is requiredSlide5
Fluid volume deficit
a reduction in body fluids – “dehydration”Slide6
Intake (Input)
Liquids a person drinksSemi-liquid foodsGelatinSoupIce cream
Pudding
Yogurt
(Nurses also figure IV solutions, medications, blood, etc.)Slide7
Output
UrineFeces (including diarrhea)Vomitus
(Nurses also figure blood loss, chest tube output, drainage tubes, etc.)Slide8
Input -Measurement
Know the sizes of the containers your facility usesConvert all measurements to milliliters (ml) Slide9
Output - Measurement
Always remember to protect yourself with the proper PPEKeep container level on a flat surface while measuring
Prevent splashing or spilling
If splashing is a risk: mask,goggles,& gown
After emptying contents into the toilet, rinse container and put it away
Remove gloves and wash handsSlide10
The diaper/adult brief trick
Weight of 1 US Gallon of water = approx. 8.35 lb (about 3.79 kg)One ounce of water weighs approx. one ounce.Slide11Slide12
Common Conversions
15 drops = 1 ml = 1 cc1 teaspoon = 5ml = 5 cc1 tablespoon = 15 ml = 15 cc2 tablespoons = 1 oz = 30 ml = 30 cc1 cup = 8 oz = 240 ml = 240 cc
1 pint = 16 oz = 500 ml = 500 cc
1 quart = 32 oz = 1000 ml = 1000 ccSlide13
Specimen Hat
UrinalGraduateTraditional bed panFracture bed panSlide14
Intake
By Mouth: all fluids and foods that are liquid at room temp.Tube Feeding: Recorded as oral intake or a special column.Used for patients who are unable to swallow, the unconscious or comatose.
Solution contains all nutrients required by the body
and is more nourishing than IV feedings
Given through NG (
nasogastric
) or G (
gastrostomy
) tubeSlide15
Patient will be in a mid fowlers position during feeding and for 30-60 min following.
Make sure there are no kinks in tubing, caution is used when turning or positioning a patient, give frequent oral hygiene, notify nurse if alarm sounds…solution is not flowing…solution is low or emptyIV (Intravenous)
Fluids given into a vein
Includes blood units, plasma, and other solutionsSlide16
Irrigation
-fluids placed into tubes that have been inserted into the body.Any fluid removed after irrigation is not intakeIf nasogastric
tube is irrigated with 80
mL of solution and exact amount is drawn back out, this is not recorded as intake.
However, if 60
mL
is drawn back out, 20
mL
is recorded as irrigation intake
Measurement Is Responsibility of Nurse or other legally authorized team member. (IV, Irrigation, tube feeding)Slide17
Output
-refers to all fluids eliminated by patientBowel Movement (BM)Liquid BM measured and recordedSolid or formed BM is usually noted in remarks column or described under feces.
Nurse assistant may measure/record
EmesisMaterial vomited is measured and recorded
Color, type, and other facts are noted in remarks
Nurse assistant may measure/recordSlide18
Urine
All urine voided is measured and recordedUrine drained by catheter is measured and recordedNurse assistant may measure/record
Urine output of less than 30
mL per hour must be reportedIrrigation
Irrigation or suction drainage is measured and recorded
Drainage included from NG tube, chest tube, other tubes
Type, color, and other facts are noted in remarks column
Excess is recorded as output.Slide19
Records must be accurate
All amounts are measured in graduatesContainer made of plastic or stainless steelHas calibrations for milliliters/cubic centimeters and/or ounces on the sideSimilar to a measuring cup
Graduate should be held at eye level or placed on solid surface and viewed at eye level to accurately record amounts
Be careful adding or totalingTotals are for 8-hr and 24-hrSlide20
Recording I’s & O’s
Some agencies keep record at bedsideTeam members note I and O of patientRecord measurements on I and O record
At times, patients are taught to record I and O
Other agencies keep record in patient chartMeasurements are noted on a sheet of paper and reported.
Nurse, unit sec., or authorized team member records info on Is and Os.Slide21
Give careful instructions for I’s and O’s
Patient must inform healthcare worker when they drink fluidsCan recorded glasses of water or quantity remaining in a filled pitcher.Assistants must think about fluid intake every time a glass, cup , or water pitcher is removed from the room.
Amounts must be recorded if a guest brings in fluids.Slide22
Females: used a bed pan or specimen hat
Males: use a urinalPatients must not place toilet tissue or expel BMs into bedpan or urine collectorIf patients are given correct instructions, they can cooperate so accurate records can be maintained.Slide23
Standard Precautions
Includes Urine, emesis, liquid bowel movements, and drainage.Gloves must be worn when fluids are measured and discarded.Hands must be washed frequently and immediately after removal of gloves
If splashing or spraying of fluids is possible, a mask, eye protection, and a gown must be worn
Graduate must be used for one patient only, and discarded or sterilized when output is no longer measured.
Areas contaminated by body fluids must be wiped with a disinfectantSlide24
Basic principles for completing
I and O recordsUse a blue or black ink penFind correct timeFind correct column (oral intake, urine output)
Record correct amount
Recheck all entriesEnter observations: color, typesAll information for an 8-hr time period is recorded, total each column separately to calculate the 8 hr totalSlide25
When all 8-hr time periods have been totaled, add the 3 8-hr totals for each separate column
This gives a 24 hr totalSome charts are 24-hr without 8-hr incrementsRecheck all additionError: draw one red line through error, initial in red
Final check:
All entries correct, comments are noted in remarks column, addition is accurate, entries are neat and legible.