NUR 111: Intake and Output

• Intake and output is relevant to nursing course NUR 111 in Fall 2024.

Strict I & O

• Strict I & O is used to monitor fluid volume deficit.
• Strict I & O is used to monitor volume excess.

Reasons for Strict I & O

• Medications can be a reason to monitor strict I & O.
• Medical conditions can be a reason to monitor strict I & O.
• Trauma can be a reason to monitor strict I & O.
• Pediatrics can be a reason to monitor strict I & O.
• Post-surgical monitoring can be a reason to monitor strict I & O.
• Fluid & electrolyte imbalance can be a reason to monitor strict I & O.
• Post catheter removal can be a reason to monitor strict I & O.

Weight Conversion

• To convert kilograms to pounds, multiply by 2.2.
• To convert pounds to kilograms, divide by 2.2.
• When calculating weight conversions for adults and children, calculate to 4 numbers past the decimal.
• Do not round the fourth number in weight conversions.

Urine Output Calculation/Day

• Infants: 2-3 mL/kg/hour
• Toddlers: 2 mL/kg/hour
• School Age: 1-2 mL/kg/hour
• Adolescents: 0.5-1 mL/kg/hour
• Adults: 0.5 mL/kg/hour

Water Weight Loss or Gain

• 1 kg or 2.2 pounds loss or gain in a 24-hour period equals 1000 mL loss or gain.
• 5 pounds or 2.2 kg loss or gain in a week is significant.

Infant Weight with Diapers

• Weigh in grams a fresh, unused diaper.
• Weigh in grams, a used diaper.
• Used diaper grams minus fresh diaper grams equals the difference in grams, which is equal to the mL of urine output.
• Example: A difference of 2 grams means the urine output is approximately 2 mL.

Liquid Conversions

• 1 oz = 30 mL
• 1 home cup = 8 fluid oz = 240 mL
• 2 cups = 1 pint = 16 fluid oz = 480 mL
• 2 pints = 1 quart = 32 oz = 960 mL
• 1 teaspoon = 5 mL
• 1 Tablespoon = 15 mL

Fluid Considerations

• Anything that becomes liquid at room temperature counts as fluid.
• Examples of fluids: Juice, water, tea/coffee, Jell-O, milk, ice cream/sherbet/sorbet, popsicle, Ensure/Boost, broth, IV fluids/flushes, blood products, TPN/lipids, NG tube feeding/flushes/irrigations, and bladder irrigations.
• Ice chips count as one half the amount.

Fluid or Not Fluid

• Pudding is not a fluid.
• Custards are not a fluid.
• Thickened gravy is not a fluid.
• Yogurt is not a fluid.

Output

• Urine is an output.
• Emesis is an output.
• Diarrhea is an output.
• Ostomy (liquid stool/urine) is an output.
• Drains (chest tubes, Hemovac, Wound Vac, Jackson Pratt, NG tube drainage, etc.) are outputs.

Fluid Loss

• Types of fluid loss:
  • Insensible fluid loss: Respirations, perspiration.
    • Usually about 600 mL/day.
  • Sensible fluid loss: Sweat , urine, liquid feces, wound drainage in JP, wound vac, and chest tubes.