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Measuring Intake and Output

Unit 7 Lesson 5

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Explain the process of measuring intake and output
Identify differences between normal and abnormal intake and output
Describe the role of the nurse’s aide in the documentation and reporting of abnormal intake and output

Student Learning Outcomes

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Intake and Output

Intake

Total fluids ingested, including drinks and liquid foods

Output

Fluids leaving the body through urine, sweat (not measurable), and other means

Importance of Monitoring

Maintains fluid balance for health stability
Essential for diagnosing and managing medical conditions

Sandquist-Reuter, 2023

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Measuring Intake

Record all fluids consumed

Water
Juice
Soups
Anything that is liquid at room temperature Juice

Ice chips (NOTE: This melts to half its volume. If the patient is given 8 oz of ice chips RECORD 4 oz)
Milk
Tea
Gelatin (Jell-O ®)
Broths
Ice cream
Frozen treats: popsicles, sorbet
Nutrition supplements like Ensure® or Boost

Sandquist-Reuter, 2023

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Measuring Intake continued…

Use milliliters (mL) for documentation

1 ounce = 29.5735 mL

Note any special intake instructed by healthcare providers

Example: Fluid restrictions

Sandquist-Reuter, 2023

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Measuring Intake continued…

Tools for Measurement

Graduated cups
Measuring spoons

Ensure proper calibration of measuring tools

Sandquist-Reuter, 2023

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Measuring Output

Urine

Most commonly measured
Use a urine collection device

Other Outputs

Vomit
Wound drainage
Liquid stools

Use charts to document outputs consistently

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Measuring Output continued…

Understanding Insensible Losses

Fluids lost through breathing and sweat
Not measurable but considered in overall fluid balance

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Sample Intake & Output Documentation Record

Sandquist-Reuter, 2023

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Critical Thinking Question

A client is on a strict fluid intake restriction due to heart failure. The nurse’s aide is responsible for measuring their intake. The client consumed a bowl of soup (240 mL), a cup of coffee (180 mL), and a glass of water (240 mL) during the nurse’s aide shift. What should be recorded as their total fluid intake?

A) 420 mL

B) 660 mL

C) 800 mL

D) 1000 mL

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Normal vs. Abnormal Intake and Output

Normal Intake and Output

Balance indicates adequate hydration and bodily function
Typically measured over a 24-hour period for accuracy

Identifying Abnormalities

High Output may indicate

Diabetes
Diuretics effect
Kidney issues

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Normal vs. Abnormal Intake and Output continued…

Identifying Abnormalities continued…

Low Output may indicate

Dehydration
Kidney failure
Shock

Immediate reporting of abnormal patterns is crucial

Sandquist-Reuter, 2023

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Critical Thinking Question

A nurse’s aide is caring for a client with a urinary tract infection. The client's intake over the past 24 hours includes 1500 mL of fluids. However, the nurse’s aide notices that the output recorded is only 500 mL of urine.

What actions should be taken based on the intake and output information?

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Role of the Nurse Aide in Documentation

Documentation Process

Accurate and timely recording using standardized forms
Include details such as time, amount, and type of fluid

Monitoring and Reporting

Observe trends and patterns in intake and output
Report discrepancies to the nurse promptly
Collaborate with healthcare team for patient care planning

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Role of the Nurse Aide in Documentation continued…

Special Considerations

Be aware of patient-specific instructions
Examples: Restricted fluid intake; Increased monitoring needs

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Critical Thinking Question

While documenting a client’s output, the nurse’s aide notices the urine is dark and has a strong odor. The client’s intake has been 2000 mL over the past 24-hour period, but they have only voided 700 mL. What should the nurse’s aide do next?

A) Record the findings and continue with tasks.

B) Increase the client's fluid intake to improve urine output.

C) Inform the nurse about the discrepancy and the urine characteristics.

D) Wait to see if the client's output improves before taking action.

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References

Sandquist-Reuter, M. (2023). Nursing Assistant. WisTech Open. https://wtcs.pressbooks.pub/nurseassist/

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