Question

Your shift is from 7a-7p. The patient had the following intake and output during your shift. Based on your calculation, the patient is at risk for?

0800: 8 oz orange juice, 6 oz yogurt, slice of bread, 10 cc flush
1000: 8 oz coffee w/ 1 oz of cream
1200: 12 oz soda, Two 12 oz cherry popsicles, 3 oz chocolate pudding, 4 oz chicken broth
1300: 6 oz soda, 12 oz custard
1600: 8 oz ice chips
1400-1900: 50 cc/hr IV infusion
0700: 500 cc urine
1100: emesis 100 cc, ileostomy stool 350 cc
1200: wound vac drainage 200 cc
1300: 250 cc urine
1500: JP drain 400 cc
1700: 350 cc urine
1730: 400 cc urine
1800: 350 cc urine
1830: ileostomy stool 400 cc
1845: 500 cc urine

A. Intake: 2080 mL & Output: 3520 mL; monitor the patient for dehydration
B. Intake: 2270 mL & Output: 3800 mL; monitor the patient for dehydration
C. Intake: 3890 mL & Output: 2200; monitor the patient for fluid volume overload
D. Intake: 4005 mL & Output: 2270 mL; monitor the patient for fluid volume overload

Answer 1

The patient's intake during the shift was 4005 mL and output was 3520 mL, which suggests the risk of fluid volume overload. The values were obtained by converting and summing all liquid intakes and outputs. It is important to compare this with the norms for daily water input and output for appropriate patient care.

Step-by-step explanation:

When calculating the intake and output of a patient during a 12-hour shift (from 7 a.m. to 7 p.m.), it is essential to convert all measurements to the same units (milliliters in this case) and then sum up the total intake and output volumes.

• Intake: Includes fluids from drinks, foods that are liquid at room temperature (such as ice chips and popsicles), and intravenous infusions.
• Output: Includes urine, emesis, wound drainage, and output from drains or stomas.

After converting all intake and output amounts to milliliters and summing them up, the patient's intake is 4005 mL and output is 3520 mL for the time frame specified. When analyzing these results, it's clear that the patient's output is less than their intake. Therefore, the patient should be monitored for fluid volume overload as there is more intake than output. This conclusion is critical in guiding appropriate patient care.

It is also important to note that the typical daily water intake and loss should be balanced, with normal urine production being 1.5 liters per day. Water is also lost through insensible water loss, and urinary output can vary based on factors such as hydration level and medical conditions.