Monitoring intake and output (I/O) balance is important to check fluid status. Nurses should record hourly or daily intake including oral, enteral, and parenteral fluids and output including urine, drainage, vomiting, and other losses. Intake should equal output for balanced status, while a positive balance means intake exceeds output and negative balance means output exceeds intake. Examples calculate intake of 1860 ml and output of 1650 ml over 12 hours for a positive 210 ml balance, and intake of 1650 ml and output of 1860 ml for a negative 210 ml balance.

1. Intake output

2. INDICATION
• WHAT ARE THE INDICATION OF MONITORING
I/O BALANCE?

3. Important points
• Check for an order –intake output (I&O)
measurement . Hourly/ 24hours
• Review record and analyze trend in I&O
measurement , vital sign, lab finding, weight.
• Inspect all IV fluids –Drip/infusions
• Notice – Suction container, drainage
• Inform patient & family the plan for I&O
measurement
• Keep a paper and pen at bed side

4. Intake
• All fluid entering body
• ENTERAL- WATER,JUICE ,JUICE,MILK, feeding
via naso gastric or PEG tube.......
• PARENTERAL- IV FLUID / (TPN )FEEDING /
BLOOD TRANSFUSION/
FLUSH/MEDICATION..........

5. OUTPUT
• FLUID LEAVING BODY
• URINE,DIARRHEA,VOMITING,DRAINAGE- NG
drainage, INTERCOSTAL/
COLOSTOMY,ILEOSTOMY, BLEEDING, WOUND
DRAINAGE etc

6. Intake and Output calculation
• Normally intake should be = to output
• If intake is more than output you call it as
POSITIVE BALANCE.
• If Output is more than intake you call it as
NEGATIVE BALANCE

7. Intake & Output chart

8. Situation 1

9. Calculate intake for 12 hours
• A patient recorded following in a sheet
• Breakfast – 1egg, toast -2,one cup of
coffee(180ml) and small orange juice(120ml)
• Lunch sandwich ,apple , one glass tea (240ml)
• Dinner – chicken, rice, 2 glass tea
• Between meal : 4 glasses of water(one glass
water 120ml)
• IV fluid (Nacl) =30ml/hour

10. Answer =Calculate intake for 12 hours
• one cup of coffee=180ml.
• orange juice= 120
• Three glass tea = 3 x 240 = 720ml
• 4 glasses of water= 120 x 4 = 480ml
• IV fluid (Nacl) =30ml/hour x 12 hours = 360ml
TOTAL INTAKE FOR 12 HOURS =
180+120+720+480+360= 1860ml.

11. Situation 2

12. Calculate output for 12 hours
• A patient recorded the following amount
voided on a sheet of paper.
• 400ml at 7:00am; 100ml at 10:00am;at 12
noon 200ml;150ml at 2:00pm;400ml at
6:00pm.
• Nurse emptied 300 cc from wound drainage
bag , patient vomited 100cc at 4:00pm
• What is out put for 12 hours

13. Answer output for 12 hours
• Urine voided = 400ml + 100ml+200ml+150ml
+400ml = 1250ml.
• wound drainage =300 cc
• Vomited 100cc
Total out put for 12 hours = 1250+300+100 =
1650ml

14. Calculate the I&O BALANCE
TOTAL INTAKE FOR 12 HOURS = 1860ml.
Total out put for 12 hours = 1650ml
• Intake – Output = Balance
• 1860 – 1650 = + 210ml
Interpretation = Positive balance

15. What is the I&O BALANCE if :
TOTAL INTAKE FOR 12 HOURS =1650ml
Total out put for 12 hours =1860ml
• Intake – Output = Balance
• 1650 –1860= - 210ml
• Interpretation = negative balance