Intake and Output

Calculation
Prepared by :
Miss . Salwa Maghrabi

Outline

Definition of intake and output calculation .

The purposes of intake and output calculation.
The procedure :

Equipment .
2. Assessment .
3. Implementations .
4. Documentation .
Negative and positive balance .
Situations .
1.

Objectives
1.
2.

3.
4.

List the purposes of intake and

output calculations .
Mentions the parameters of
assessments before intake and
output calculation .
Discribe the negative and positive
balance.
Determine who to calculate the
intake and output .

Intake and Output Calculations

The process involves recording all the fluid that

goes into the patient and the fluid that leaves
the body.
Normal conditions the intake should equal
output in 24 hours.
Ex of intake :
1.
2.
3.

Liquids taken PO .
Intravenous fluids (IV) .
Feedings via nasograstic or PEG tubes.

Ex of output :
1.
2.
3.

Urine or liquid feces.

Blood.
Drainage from wounds or suction.

The purposes of intake and output

calculation
1.
2.
3.
4.
5.

Ensure accurate record keeping.

Prevent circulatory overloud.
Prevent dehydration.
Aids in analyzing trends in fluid status.
Contributes to accurate assessment
record.

The Procedure
The Equipment :
Intake and output chart.

Assessments
1. Check the kardex or listen in report to
determine if an assigned client is on I&O.
2. Verify during report how much IV fluid has
been accounted for from any currently
infusing solution.

Assessment
3. Review the nursing care plan.
4. Review the clients medical record and
analyze trends in I&O, vital signs
measurements, laboratory findings, and
weight records.

Cont. Assessment
5. Perform a physical assessment .
6. Inspect all tubings and drains .
7. Notice if all suction containers or drainage
containers were emptied .

Cont Assessment
Determine how much the client
understands.
9. Look for a calibrated container and
bedside I&O record.
10. Obtain a collection device for inside the
toilet
11. Measure the amount of water in the
clients bedside.
8.

Implementations
1.
2.
3.

Explain the purpose and procedures for

measuring I&O to the client.
Record the volume for all fluids
consumed.
Make sure that all IV fluids or tube
feedings are being administered at the
prescribed rate.

Cont Implementations
4.
5.
6.
7.

8.
9.

Ensure that the nurse who adds additional

IV fluid containers also records 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 a catheter drainage
bag, liquid stool or other.
Wash hands .
Check the volume remaining in currently
infusing IV fluids.

Cont Implemenations
10. Record

the total amount of all fluid

intake and output volumes.

11. Compare

the data to determine if the

intake and output are approximately the
same.
12. Report major differences in I&O to the
clients physician.

13. Review

the plan of care and if the goals

have not been met.
14. Report the I&O volumes IV fluid credit
amount, and or other data.

Documentation
Date and time.
Intake and output volumes for the next shift

1.
2.

Negative and positive balance:

If the total intake for the shift > the total

output for the shift
negative balance .
If the total intake for the shift the total
output for the shift
positive balance .

Situation 1
A patient has recorded the following on a sheet of
paper at the bedside:
Breakfast: eggs, toast, one cup of coffee (180 ml );
small orange juice (120 ml ).
Lunch: sandwich, apple, glass of tea (one glass of
tea 240 ml )
Dinner: chicken, broccoli, rice, 2 glasses of tea
Between meals: 4 glasses of water ( one glass of
water 120 ml ).
1000mL of D5 W infusing IV at 30 mL/hour
Calculate the intake for 12 hours shift ?

The Answer
one cup of coffee =180 ml .
small orange juice = 120 ml .
3 glass of tea = 3 240 = 720 ml .
4 glass of water = 4 120 = 480 ml.
30 ml IV fluid 12 hours = 360 ml

Total intake for 12 hours = 180+ 120 + 720

+ 480 + 360 = 1860 ml .

Situation 2
The patient recorded the following amounts
voided on the sheet of paper: 400 cc at
7:00 am; 100cc at 10:00 am; 200cc at 12
noon; 150 cc at 2:00 pm; 400cc at 6:00pm.
The nurse emptied 300cc from a JP tube. The
patient vomited 100cc at 4:00 pm What is
the total output for the 12 hour shift.
Calculate the output for 12 hours ?

The Answer

Urine voided = 400 cc +100cc +200cc +150 cc

+400cc =1250 ml
300cc from a JP tube.
The patient vomited 100cc.

The total output for 12 hours = 1250 + 100 +

300= 1650 ml .