Urinary output

  1. 0
    Hi all just a quick question................The other day I had a patient whose urinary out put was 650 on day shift 150 on eves and 200 on my shift (noc's). My belief is that he exceeded the normal urinary output per day (500) so I was not overly concerned, however when day shift nurse arrived she was VERY concerned and wanted to know why I had not called the MD. Am I missing something here? Her thought is that all patient's should be producing at least 30 cc's per hour or 240 per shift...............What do you think?????
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  4. 0
    The correct amount is 0.5 - 1 ml/kg lean body weight. I use that calc and although it is a paediatric calc it gives a better guide than the standard x amount per hour. I would not have been overly concerned as the UO does tend to naturally drop off at night.
  5. 0
    It depends on what your patient is there for. Do they have IV fluids running? Did they have lasix in the morning? What were the vitals, hydration status? Also it is to be expected that they have less output during the night because they are not drinking anything. I am assuming they were sleeping most of the time.

    ETA: I would have been more concerned about the evening shift output.
    Last edit by stella123 rn on Oct 2, '03
  6. 0
    i'm with the previous posters.

    data should never replace sound clinical judgement or assessment.

    do they have a bloodpressure? are the tacchycardic? are they normothermic? do the have clear lungs? do they look dry, septic, wet, or stable? just becuase the text says this is how much pee makes you normal it is not that the average human doesn't make more or less that the average.

    i think that urine output is the thing that is most overlooked. however, the most important thing is that the patient has normal renal function and they are making urine consistently.

    what if the patient made all their daily requirment of urine in one shift? does that mean that we don't have to worry for the next 16 hours? 200cc over an 8 hour period is not alarming unless they were getting IV fluid at a high rate or boluses.

    i have a feeling she was playing:
    'obviously i'm a better nurse than you'
    without good reason. i always hated that when change of shift came.

    did your relief nurse PEE EXACTLY 240CC before she came in that morning????? she/he must be really hard on those dialysis patients.
  7. 0
    I would say that 350 that the last 16 hours was something to be concerned about. But as was stated before you have to look at the overall picture. What was the intake. Some people drink less at night. Was there a stable running IV the entire time? What was total intake verses output.

    I go with the golden oldie standard of at least 30 cc an hour, and not take into account the 24 hour total, but look at what's happening now. If u.o. starts to drop, even if they were 650 the previous shift, I call the MD if her physical assessment warrents it.
  8. 0
    We use the 30cc/hr standard....give or take 5 cc's either way unless there is concern about fluid volume, like right after a major gut surgery. I say that you have to take into concideration why the pt is there is the first place, are they on fluid restriction, have they been vomiting and so forth, if clinically their VS are stable and they appear to have good CV status, I might mention it in passing to the next shift but I don't think that I would jump up and down and get all excited unless there were other things happening that would cause a concern for < 30cc/hr


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