Adequate urine output

[SheaTab]

Hi wonderful, fabulous, RockStar nursing students!

While working in the clinical setting with my students over this last semester, I realized that most all of them have been taught that 30 mL urine output is adequate and have generally applied this to all patients. I just wanted to get the truth out to a wider audience.

The appropriate UOP is at least 0.5 cc/kg/hr. The smaller the patient, the less the blood volume & metabolic waste. The reverse is also true. A larger patient will need to produce more urine.

If you stick to the 30 cc/hr rule that many of us were taught, you might miss a very important sign that a patient's kidneys are compromised.

Example:

150 lb patient: 68 kg x 0.5 = 34 cc urine/hr

400 lb patient: 182 kg x 0.5 = 91 cc urine/hr

I just wanted to put this out there because I suspect that many of you might have that 30 cc figure stuck in your head and a 400 lb patient might be in acute renal failure with an output of only 30 cc/hr. Make sense? There are a lot of morbidly obese patients these days so it is important to understand this concept.

Keep Rocking!

I :heartbeat nursing students!

Tabitha

[TheCommuter, BSN, RN]

Thanks for this helpful information!

In addition to the 30cc per hour rule, my classmates and I were also taught that 1500mL per 24 hours is adequate urine output in most cases. However, 1500mL divided into 24 hours would equal 62 to 63mL hourly, which would be grossly inadequate for the 400 pound patient in your example.

Again, thank you so very much!

[Isitpossible, LPN, LVN]

sheatab- thank you!! we were also drilled 30cc/hr is the normal...never took into account pt weight..i will pass this along to the other students! thanks!

[SolaireSolstice, BSN, RN]

I was taught that 30/hr is the MINIMUM amount of urine output expected for an adult.

[dozndawg]

I would like to add that these coomon values that we are taught are just that...common...for the 150 lbs 25 yr old male in good health. I would surely love to get any other values you may think of that need to be appropriately adjusted... I know many straight "A" students who can NOT see beyond their books...so if they were not taught it they may take years or mistakes to learn it. So, any input would be greatly appreciated and duly noted in my clinical "cheat book" (reference). I am always a learner and love to see beyond the big picture.

[Alternator81]

We were taught that 30mL is a CRITICAL value, meaning that the patient is surely is or will be in kidney failure if the output drops below 30. We were taught to look at the tend of the patient's urine output as the best indicator, such as a pt's urine output being 150-200 mL/hour during a hospitalization and then suddenly dropping to 70 or 60.

[SheaTab]

I would like to add that these coomon values that we are taught are just that...common...for the 150 lbs 25 yr old male in good health. I would surely love to get any other values you may think of that need to be appropriately adjusted... I know many straight "A" students who can NOT see beyond their books...so if they were not taught it they may take years or mistakes to learn it. So, any input would be greatly appreciated and duly noted in my clinical "cheat book" (reference). I am always a learner and love to see beyond the big picture.

I'm proud of you for for making it a priority to learn as much as you can! Never stop learning and growing.