The document outlines the importance of accurately measuring and recording fluid intake and output for patient health assessment, particularly in critically ill patients. It defines intake as all fluids entering the body and output as all fluids leaving the body, highlighting the significance of these measurements in preventing dehydration and fluid overload. The document also emphasizes the need for proper documentation, patient monitoring, and understanding of fluid balance in nursing care.

1. Welcome

2. Intake & Output Chart

3. Introduction:
Water is essential for life and maintaining the correct
balance of fluid in the body is crucial to health.
Measuring intake and output chart is one of the most
basic methods of monitoring a client’s health. Accurate
24 hours measurement and recording is an essential part
of patient assessment. In critically ill patent it becomes
very important to accurately record fluid intake and
output for proper evaluation and control of fluid
balance. Accuracy in recording fluid intake and output
is vital to the overall management of certain patient
groups and facilitate correct prescribing of intervention
and Subcutaneous fluids.

4. Definition of Intake:
Measurement of all those fluids entering the
clients body such as water ,ice chips, juice, milk,
coffee, ice-creams and fluid include: Parenteral,
central line, feeding tube ,artificial irrigation and
blood transfusion.

5. Definition of Output:
Measurement of all fluid level that leaves
the clients body such as urine,
perspiration, exhalation, diarrhea,
vomiting, drainage, bleeding and wounds

6. Definition of intake and output chart:
Measurement of a patient’s fluid intake by
mouth, feeding tubes or intravenous catheters.
And output from kidneys gastrointestinal tract,
drainage tubes , and wounds accurate 24 hours
measurement and recording is an essential part
of patient assessment.

7. Body fluid compartments:
To make a competent assessment of fluid balance, nurses need
to understand the fluid compartments within the body-
Compartments Fluid content
Intracellular compartment (inside the
cell)
Intracellular fluid
Extra cellular compartment (outside the
cell )
Extra cellular fluid
Intercellular compartment/ Interstitial
space (Between the cell)
Interstitial fluid or intercellular fluid.
Intravascular compartment ( in blood) Plasma

8. The purpose of intake and output calculation:
 Ensure accurate record keeping.
 Prevent circulatory overload
 Prevent dehydration
 Aids in analyzing trends in fluid status
 Contributes to accurate assessment record.

9. Indication of intake and output chart:
Fluid and electrolyte imbalance.
Kidney impairment patient’s.
In case of dialysis patient’s.
Client’s with burns.
Recent surgical procedure.
Severe vomiting or diarrhea.
Taking diuretics or corticosteroids.
Congestive heart failure.
In case of dehydration.

10. Decreased or little urine output
Dry mucous membrane.
Any bleeding.
Excessive perspiration.
Dark concentrated urine.

11. Importance of measuring fluid intake and output
chart:
Physician diagnosis and treatment may depend on accurate
measurement of intake and output.
Measurement of intake and output can monitor progress of
treatment or of a disorder.
This provides information about retention or loss of sodium
and ability of the kidneys to concentrate or dilute urine in
response to
Fluid change.

12. Daily physiological fluid balance:
Intake Output
o Ingested liquid : 1500 ml
o Ingested food : 800 ml
o Metabolism : 200 ml
o kidney : 1500 ml
o Skin loss : 600 ml
o GI : 100 ml
o Lung : 300 ml
Total = 2500ml/day Total = 2500ml/day

13. Why are Intake and output chart so
important
Its helps us determine the patient’s fluid status-
1. Are they hydrated?
2. Are they Dehydrated?
3. Are they fluid overload?
4. Is there an obstruction?

14. Percent of water in the human body:

15. Measuring fluid intake and output :
Intake
 Ice chips
 Juice
 Coffee
 Yogurt
 Jelly
 Intravenous/ Tube feeding
 Catheter or tube irrigants
Anything liquid at room temperature.

16. Output :
The amount of fluid is eliminated by body:
Emesis
 Urine
 Blood/ Drainage
 Liquid stools
 NG drainage
 Vomiting
Watery stool

17. Significance of measuring Intake and output :
• Inform
• Required
• Explain
• Emphasize

18. Equipment : Intake and output chart:

19. Cont……
Paper and pencil

20. Cont…….
Calibrated drinking glass

21. Cont…….
Bed side commode

22. Cont…….
Male and female urinal:

23. Cont…….
 Weighting Scale
 Calibrated container to measure output
 Gloves

24. Procedure:
 Explain the purpose and Procedure for measuring Intake & Output
to the Patient.
 Record the volume for all fluids consumed.
Make sure that all I/V fluids or tube feeding are being administered
at the prescribed rate.
 Ensure that the nurse who adds additional I/V fluid containers also
record 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
catheter drainage bag, liquid stool on other.

25. Cont…..
 Monitor vital sign
Wash hand.
 Check the volume remaining currently infusing I/V fluid.
 Record the total amount of all fluid intake and output volumes.
 Compare the data to determine if the intake and output are
approximately the same.
 Report major difference in Intake & Output to the client’s
physician.
 Review the plan of care and if the goals have not been met.
 Report the Intake & Output volumes Intravenous fluid credit
amount and other data.

26. Documentation:
 Date and time
 Intake and Output volumes
for the next shifts.

27. Chart:
Date Time Name of
Drug
Urine Suction Signature
05.09.2018 12.00 PM Injection :
Cefuroxime 750
mg, IV
300 ml 30 ml
Infusion:
Normal saline
1000 cc

28. Complication of patient if intake and output
chart is not maintain accurately:
 Fluid balance-
A. Dehydration:
• Fever is present.
• There is decrease in urine.
• Urine is contracted.
• Weight loss occur.

29. Cont……
• Membrane are dry and it is difficult to swallow.
• Tongue is coated thickened.
• Skin becomes hard and cracks and is dry and warm.
B. Edema:
• Decrease in urine output.
• Gain in weight.
• puffiness or Swelling
•Sometimes shortness of breath.

30. Nursing care plan:
Nursing Diagnosis Goal Nursing Intervention Evaluation
Deficit fluid
volume related to
excessive urine
output
Maintain
Adequate fluid
balance
 Maintain fluid balance.
 Electrolyte Imbalance
maintain.
 Administration
Intravenous of fluid.
 Additional potassium as
prescribed.
 Monitor cardiac
Manifestations of
hypokalamia.
Gradually
maintain
Adequate
fluid
balance
Risk of edema due
to excess fluid
volume.
Maintain
Normal fluid
volume
 Assess the excess fluid
volume.
 Administer diuretics
according to doctor order.
 Monitor vital sign.
 Record output and urine
specific gravity.
Gradually
maintain
fluid
volume
according
to body
needs.

31. Nursing Diagnosis Goal Nursing Intervention Evaluation
Deficit
Knowledge about
intake and output
chart.
Demonstrated
knowledge to
the patient
about intake
and output
chart.
 Give general knowledge
about the procedure and its
important.
 Teach about normal color of
urine.
 Teach to take adequate
amount of fluid.
 Teach the patient to report
any sign of dehydration or
edema.
Patient can
demonstrated
the
knowledge
about intake
and output
chart.

32. Summery:
Assessment of fluid balance requires close observation
and monitoring of the patient, recognizing that certain
groups of patients such as the elderly and children are at
particular risk. Patient assessment must be guided by an
understanding of the basic principles of normal
physiology and how illness or injury can cause
fluid/electrolyte imbalance. Nursing assessment of fluid
balance must include knowledge of the history of the
patient, careful examination and clinical observation
and an understanding of the significance of laboratory
data.

33. Reference:
1. http://
medical-dictionary.thefreedictionary.com/intake+and+output.
2. http://www.nursing times. Net
3. http://www.Medical news today's www.medicalnewstoday.com/...285666
4. http://www.healthline.com
5. http://en.oxforddictionaries.com/definition/intake
6. http://medical-dictionary.thefreedictionary.com/output

34. Thanks