Intake & Output
37
Grant, Ellie
Dx: Intratrochanteric hip fracture (fall)
PCP: Dr. Marisol Bennett
Delegation Follow-Up
Calculate the Net I&O
Night shift ran from 2300–0700 (8 hours). Sort each card's data into the chart below.
Step 1: Sort the Data
Urine 240 mL
Coffee 4 oz
Urine 150 mL
IV Fluids 1312 mL
Water bottle 360 mL
| Time | Intake | Output |
|---|---|---|
| 0415 | ||
| 0505 | ||
| 0630 |
Step 2: Calculate
Total Intake = 4 oz coffee (≈120 mL) + 360 mL water + 1312 mL IV = 1792 mL
Total Output = 240 mL + 150 mL = 390 mL
Net I&O = 1792 − 390 = +1402 mL
Total Output = 240 mL + 150 mL = 390 mL
Net I&O = 1792 − 390 = +1402 mL
Step 3: Interpret
What does a net I&O of +1402 mL tell the nurse about Ellie's fluid status?
A net I&O this far positive means Ellie has taken in far more fluid than she's put out this shift. That's not dehydration, and it's more than "normal." It means she's retaining fluid.
Is Ellie's urine output adequate?
390 mL ÷ 8 hours = 48.75 mL/hour, above the minimum, so by volume alone, output is adequate. That said, the urine is dark and cola-colored, which is not normal regardless of volume. Adequate output does not rule out a developing problem. It just tells you flow isn't the immediate issue.
Ellie's output is adequate, but she's still significantly fluid positive. Select all findings you would monitor for to catch early fluid overload.
Lung sounds, daily weights, peripheral/sacral edema, and JVD are all early signs of fluid volume overload, the risk Ellie is trending toward. Skin turgor and bowel sounds don't help you catch overload; skin turgor actually points the other direction (dehydration), and bowel sounds aren't related to fluid balance.
One More Thing to Track
Ellie's output is adequate for now. But with intake this far ahead of output, she needs continued monitoring for fluid overload as her shift goes on.
Return to the Care Activities and complete them all until Ellie is resting comfortably.