Re: Measuring urine output

Originally Posted by THSN1975

1. I am wondering what other units do in regards to keeping track of urine output. The Level III unit I work in does not measure urine output at all.

...and I'll add...I think that the practice of not keeping track is dangerous.

Our physicians make a huge amount of decisions based on I&O...and with a patient who is smaller and obviously cannot talk...the fact that urination or defication has taken a downslide can be your first and only clue to something that is going wrong.

Otherwise, you won't know until your baby starts showing symptoms.

Our Neo's use this to decide whether or not to advance feeds, which is evaluated q 24

Re: Measuring urine output

Always weigh the diapers too, had a sick one the other noc and the NNP wanted my output in order to give addition fluids (bolus). It makes a difference in your lab values as well. I can't imagine not doing it. Some people are lazier about it than others, especially when they go to level 2 status.

To Dawn.... put in a foley??? Yikes!

Re: Measuring urine output

Originally Posted by BabyLady

...and I'll add...I think that the practice of not keeping track is dangerous.

Our physicians make a huge amount of decisions based on I&O...and with a patient who is smaller and obviously cannot talk...the fact that urination or defication has taken a downslide can be your first and only clue to something that is going wrong.

Otherwise, you won't know until your baby starts showing symptoms.

Our Neo's use this to decide whether or not to advance feeds, which is evaluated q 24

you know what?? This drives me crazy as well......I don't need a lecture, I was just wondering what other units do

Re: Measuring urine output

We'll place a foley as well if their urine output drops off or we need more specific measurements or we need to separarte urine/stool. Is that odd?

Re: Measuring urine output

We weigh diapers on all babies until discharge. Policy states all babies with a IV should have a U bag. That doesn't always get done. However, we do keep bags on really critical babies (new admits, those in a humidified enviroments, etc). We only place Foleys in cases of urine retention.

Re: Measuring urine output

Originally Posted by HappyBunnyNurse

We weigh diapers on all babies until discharge. Policy states all babies with a IV should have a U bag. That doesn't always get done. However, we do keep bags on really critical babies (new admits, those in a humidified enviroments, etc). We only place Foleys in cases of urine retention.

How do you deal with skin integrity and all of that stuff on kids with long term IVs...??? I can't imagine having to put a bag on a kid for more than a few times in a row, let along days / weeks!!!

Re: Measuring urine output

Our head neo is sort of obsessed with urine output (perhaps rightly so). That said, we wash the area with soap and water (just sterile water for the tiny ones), dry completly, then stick the bag. We let them wear it until it leaks really bad. If it is put on right then it can last a good 12 hours. We also do RUAs once a shift on all babies who are on IV nutrition. I have only seen one baby with breakdown from a u bag and she was a 23 wkr who had breakdown everywhere right before she passed (leads, IV site, temp probe... so sad). The preemie bags have flexable adhesive tabs. I really hate the bigger ones.

Re: Measuring urine output

Originally Posted by THSN1975

you know what?? This drives me crazy as well......I don't need a lecture, I was just wondering what other units do

I can see where it would. I think many posters are trying to give you "ammunition" to help you get practice changed in your unit.

I think it's fair to say that the "community Standard of Care" nationwide (and further) is to weigh diapers/measure output.

I hope that helps you. Good Luck. Unless the leadership in your unit, both medical and nursing, decides the info is needed, you really have an uphill battle. Start @ the top, and keep working to provide good care.

Re: Measuring urine output

Our ER needed a foley for a few month old baby and we didn't even stock them small enough. What fr.size do you use? We don't use diapers on anything smaller than 1000 grams, we have no wee pees we use ob sponges (the felt things) and make a sumo (sp?) style diaper. Each weighs 2 grams without pee. And we are a lg level 2. Preemie diapers on little babies drives me nuts, especially with the hips and not to mention they are so tall up the back it covers the temp probes. Some try to make their own using mole tape and cut the preemie but think of the variability on the weight of those depending upon who makes them up during their shift, I don't do it.

Re: Measuring urine output

We will use a 5fr feeding tube as a catheter on our babies. Works pretty well. But we have to make sure to use the old style ones - the ones that connect to both feeding tubes and IV syringes, not our new orange feeding syringe only ones. This way, we just connect the end of the feeding tube up to the rest of a normal foley set-up.