Transcript 20.5 Intake and Output Presentation

Intake and Output
Unit 20.5
pages 728-733
LEQ: What does a patients
I/O record tell you about
their overall health?
Why are they so Important??
• It helps us determine the patient’s fluid
status:
• 1. Are they Hydrated?
• 2. Are they Dehydrated?
• 3. Are they in Fluid Overload?
• 4. Is there an obstruction?
Intake
1. Oral Fluids: Water, Ice, Beverages
2. Semi-Liquid Foods: Pudding, Jell-O,
Custards, Yogurt
3. Parenteral Fluids: IV Fluid, Medications,
Blood Products
4. Any Food Liquid at Room Temperature:
Popsicles, ice cream, and frozen yogurt
Measuring Output
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Emesis Basin
Foley Catheter
Graduated Cylinder
Urinal
Fractured Bedpan
Estimates ( Unless Strict I/O is
Ordered)
Urine Identification
page 603
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Straw Colored (WNL)
Dark Orange or Yellow (Concentrated)
Foul Smell (UTI)
Sediment (UTI or Kidney Failure)
Blood (Severe UTI, STD,
Hemorrhage)
Output
1. Urine: Normal Voiding, Diapers,
Ostomies, Ileal Conduits
2. Stool: Liquid Stools from Diarrhea
3. GI Suctioning
4. Wound Drainage
5. Vomiting
6. Sweating
7. Respirations
Items to Keep in Mind
• Measure Fluids instead of guessing
• Estimate and Record Fluid Loss from
Incontinence (1oz = 30cc)
• Record and Report the Intensity of
Diaphoresis
• Record Ice Chips Appropriately ( It is
usually ½ the Volume of Fluid)
• Use the Code Key Provided for You
What To Look Out For
• 1. Is the patient drinking at least 1500cc a
day (Unless they are on Fluid Restrictions)
• 2. Urinates at least once in an 8 hour shift or
urinate less than 30 cc an hour (240cc/8hrs)
• 3. Has concentrated or foul-smelling urine
• 4. Has Dry Skin
• 5. Has a temperature above 99 degrees
• 6. Is perspiring excessively
• 7. Has excessive wound Drainage
Possible Causes of Fluid Excess
• Kidney Disease
• Liver Disease
• Certain Medications : Steroids or a Sodium
Based Medication
• Abnormal Fluid Accumulation in Body
Cavities
• Overinfusion of IV Fluids
• Pregnancy
Signs and Symptoms of Fluid Excess
• Edema or Ascites: Abnormal accumulation of
fluid in the spaces between the cells (interstitial)
• Rapid Weight Gain: Fluid Accumulation will
increase overall weight
• Increased Blood Pressure: May indicate
accumulation of fluid within the circulatory
system
• Taut Skin: Shinny Skin may indicate Edema
• Shortness Of Breath: Excess fluid pools in the
lungs
Possible Causes of Fluid Loss
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1. Hypovolemic Shock
2. Excess Body Drainage
3. Diarrhea
4. Medications (diuretics)
5. Difficulty Swallowing
6. Impaired Physical Mobility
7. Postoperative Factors
8. Fever
Other Causes and Signs and Symptoms of Fluid Loss
1. Concentrated Urine: The body excreting more
solutes and less water
2. Rapid Weight Loss: A large percentage of
weight is fluid (as seen with High Protein Diets)
3. Increased Pulse: Low Fluid Volumes cause an
increase in Heart Rate
4. Decreased Skin Turgor: Loss of elasticity of the
skin due to a lack of proper hydration
5. Dry Skin: Reflects fluid loss from cells
6. Sticky Mucus Membranes: Reflects fluid loss in
normally moist tissue
7. Weakness and Confusion: Lack of fluids can
interfere with normal nerve conduction and
decreases circulation to the brain
Things to Remember Taking I&O’s
• Collect and record all I/O as it occurs and do not
rely on memory recall at the end of a shift
• Measure contents in the appropriate containers and
read at eye level.
• Remind patients to let you know if they have
taken in anything or voided
• Usually totals are taken at the end of a shift, but
keep in mind that frequent checks can increase the
accuracy of I&O’s
• Document in the appropriate area and remember
to Be Accurate
• Report any questionable output or drastic changes
in the patients condition
•LEQ: What does a
patients I/O record
tell you about their
overall health?
Clinical Prep
Characteristics of Urine page 603
Copy Table 18.1 down in your notes and be
prepared to use it to identify various
characteristics of Urine Specimens
tomorrow along with being able to
document the output.
• Identify: Urinal, Hemovac, Emesis Basin,
Graduated Cylinder, Foley Catheter,
Fractured Bedpan, and Bedpan
20.5 Clinical Prep
Characteristics of Urine page 603
• On a blank sheet of paper, number 1-15.
Using your chart, analyze the URINE
Specimens by writing down the:
– a Amount in cc’s (ALL SAMPLES)
– b Characteristic of the Sample
– c Hydrated vs Dehydrated (5-15)
– d Possible Diagnosis
• Transfer the Intake and Output from
Assignment Sheet #2 for 20.5 B
Recording Intake and Output onto the
I/O Record at the end of your packet.
Bring this with you to class Friday