CALCULATING DRUG DOSAGES
A Patient Safe Approach to Nursing and Math
Calculating Intake and
Output
Chapter 19
Copyright © 2016 F. A. Davis Company
Intake and Output (I & O)
• A record of how much liquid a patient
drinks and body fluid that is eliminated
during the shift.
– i.e., urine, wound drainage, gastric fluid,
diarrhea
• Requires the nurse to know the
measurement of food and liquid containers
used in clinical agencies.
• I&O is expressed in mL.
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Intake
• Refers to any food that is liquid at room
temperature
–
–
–
–
–
–
–
–
Soup
Juice
Coffee/Tea
Milk
Ice cream
Popsicle = 3 ounces
Gelatin
Ice Chips (melts to ½ the original volume)
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Output
• Any liquid produced by the body that can
be measured
–
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–
–
–
–
–
Urine
Emesis (vomitus)
N/G tube drainage (drains stomach contents)
Wound drainage
Diarrhea
Colostomy/ileostomy drainage
Fluids removed from special procedures
• Does not include: Blood drawn from the
vein, tears, or sweat.
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Monitoring Intake
• When a patient is on intake and output, the
nurse monitors the intake and
– adds together what the patient drinks, including
all foods that turn to liquid as a part of the
intake.
– includes formula feedings administered through
feeding tubes such as nasogastric, gastric, or
jejunostomy tubes.
– includes parenteral intake.
– records and reports the patient’s I & O for the
shift.
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Clinical Example of Recording Intake
For breakfast, the patient drank 180 mL of coffee, a 4
oz glass of juice, and 8 ounces of milk. For lunch the
patient drank 120 mL of tea and took 4 tbs of broth.
What is the patient’s intake?
• Use the metric equivalent
measurements to convert
all household
measurements to mL.
• Add the total for the shift.
7 - 3 Shift
Intake
mL
Coffee
180
Juice( 4 oz)
120
Milk( 8 ounces) 240
Tea
Broth( 4 tbs) +
120
60
620 mL
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Practice Problem #1
Recording Intake
The patient is on I & O. For breakfast, the
patient drank 90 mL of coffee and 6 ounces
of milk. For lunch the patient ate 4 oz of
gelatin and 2 tbs of ice cream. At the end of
the shift, the nurse noted that the patient had
taken 500 mL of water.
What is the patient’s intake for the shift?
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Practice Problem #1 Answer
Recording Intake
The patient is on I & O. For breakfast, the patient
drank 90 mL of coffee and 6 ounces of milk. For
lunch the patient ate 4 oz of gelatin and 2 tbs of ice
cream. At the end of the shift, the nurse noted that
the patient had taken 500 mL of water.
What is the patient’s intake for the shift?
ANSWER:
Intake
mL
Coffee
90
Milk (6 ounces)
180
Gelatin (4 oz)
120
Ice cream (2 tbs) = 30
Water
+ 500
920 mL
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Recording Intake of Ice Chips
The patient returned from a procedure and
was only allowed ice chips. The patient took
12 oz of ice chips. What is the patient’s intake
for the 7 - 3 shift?
• Recall that ice chips melt to
½ the original volume.
• In this example,12 oz melts
down to 6 oz. Actual intake
from the ice chips is 180
mL.
7 - 3 Shift
Intake
Ice chips
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mL
180
Measuring Output
The nurse measures the patient’s output by
using calibrated devices that assist in
measuring the amount of fluid output.
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Clinical Example of Recording
Output
Throughout the shift the nurse uses a calibrated
device to measure the amount of output in mL and
records the output.
The patient had 225 mL of
emesis during the shift. At the
end of the shift, the nurse
emptied 350 mL of urine from
the urinary catheter and 50 mL
of wound drainage. What is the
patient’s output?
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7 - 3 Shift
Output
mL
Emesis
225
Wound
50
Urine
+ 350
625 mL
Practice Problem
The patient is on intake and output. He has
an indwelling urinary catheter with a
continuous bladder irrigation infusing at 60
mL / hr. At the end of the 8 hour shift, the
nurse empties 775 mL from the urinary
drainage bag.
What is the patient’s output?
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Practice Problem Answer
The patient is on intake and output. He has
an indwelling urinary catheter with a
continuous bladder irrigation infusing at 60
mL / hr. At the end of the 8 hour shift, the
nurse empties 775 mL from the urinary
drainage bag.
What is the patient’s output?
ANSWER: 295 mL
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Practice Problem
The patient drank180 mL of coffee, 3.5
ounces of orange juice, 3 tsp of gelatin, and
took one 6 oz cup of ice chips.
What is the patient's intake?
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Practice Problem Answer
The patient drank180 mL of coffee, 3.5
ounces of orange juice, 3 tsp of gelatin, and
took one 6 oz cup of ice chips.
What is the patient's intake?
ANSWER: 390 mL
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Practice Problem
During the 11-7 shift the patient drank 240
mL of water. The patient’s wound drained 35
mL and the patient voided 325 mL during the
night.
What is the patient's total I & O?
I ___________
O___________
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Practice Problem Answer
During the 11-7 shift the patient drank 240
mL of water. The patient’s wound drained 35
mL and the patient voided 325 mL during the
night.
What is the patient's total I & O?
ANSWER: I 240 mL
O 360 mL
Copyright © 2016 F. A. Davis Company
Practice Problem
For breakfast the patient took 6 oz of broth, one 4
ounce cup of gelatin, and 80 mL of tea. For lunch the
patient had a 3 oz popsicle and had 2 cups of ice
chips throughout the shift. The patient urinated 225
mL at 0800 and 415 mL at 1330.
What is the patient’s total
intake and output for the
7 – 3 shift?
Intake and Output
Worksheet
Formula
Urine
Shift Oral Feeding Urine Catheter Wound
7-3
Total
(mL)
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Practice Problem Answer
For breakfast the patient took 6 oz of broth, one 4
ounce cup of gelatin, and 80 mL of tea. For lunch the
patient had a 3 oz popsicle and had 2 cups of ice
chips throughout the shift. The patient urinated 225
mL at 0800 and 415 mL at 1330.
What is the patient’s total
intake and output for the
7 – 3 shift?
Intake and Output
Worksheet
Formula
Urine
Shift Oral Feeding Urine Catheter Wound
7-3
180
225
120
415
80
90
240
ANSWER:
Total
(mL)
710
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