Intake and Output Monitoring Intake Is any measurable fluid that goes into the patient's body.

Intake includes fluids (such as water,soup, and fruit juice) and "solids" composed primarily of liquids (such as ice cream and gelatin) that are taken by mouth (orally), fluids that are introduced by IV, and fluids that are introduced by irrigation (through a tube) Output Is any measurable fluid that comes from the body. Water given off in the form of perspiration and water vapor (exhaled breath) is also output, but it is not recorded on the DD Form 792, since it cannot be accurately measured. (An adult usually looses about 500 milliliters (ml) a day through perspiration and moisture exhaled in breathing.) The major forms of output recorded on the worksheet are urine, drainage, vomitus (matter vomited), and stools (fecal discharge from the bowels). You should monitor client who have fluid imbalances or are at high risk of dehydration by calculating intake and output (I&O) each shift. Take I&O monitoring seriously. Set a realistic intake goal for each shift. Most fluid is consumed on the day shift, with the least consumed on nights. Thus, set a specific goal for each shift. Setting a goal will tell the nurse at a glance whether the client has consumed enough fluid on his or her shift. If not, the CNA should encourage fluids before leaving for the day. When establishing goals for fluid intake, fluid is usually divided as follows: * Day shift: 1/2 of total 24-hour fluid goal * Second shift: 1/3 of total 24-hour fluid goal * Third shift: 1/6 of total 24-hour fluid goal For client with a fluid restriction, total fluid allowance for each shift can be distributed in the same quantity listed above. Modify the amounts listed as necessary to personalize fluid intake to the client s individual needs. I&O monitoring is a simple procedure that does not require a physician s order. Sadly, nurses sometimes do not take this important intervention seriously. Write the need for I&O monitoring, as well as any special approaches or resident preferences, on the care plan. If the clients is known to be at high risk of dehydration upon admission, begin a temporary care plan to address this risk. Facility personnel should routinely monitor fluid balance (I&O) for the following:

All clients receiving tube feedings Clients with catheters Clients with urinary tract infections Clients with physician orders for fluid restrictions or orders to force (encourage) fluids Clients with specific physician orders for additional liquid (fluid) Clients who are known to be dehydrated or who are at risk for dehydration Clients with certain heart and kidney conditions that are at high risk for fluid imbalance Clients receiving intravenous fluids or parenteral nutrition therapy