Fluid Balance

[EP10]

I apologize if this has been posted before but I just can't seem to find a concrete answer on this.

My professor gave us this sample question:

Which of these is the best indicator of fluid balances?

A. Intake and Output

B. Skin Turgor

C. Daily Weight

D. Vital Signs

So I know right off the bat it's not skin turgor or vital signs. That leaves intake and output and daily weight.

I've seen some people claim it's daily weight and others say intake and output... Which one of these is the answer?

Thanks

[nurseprnRN, BSN, RN]

Are there more ways to lose fluid than through your kidneys? What are they? (I can think of at last three, so you'd better be able to do that.)

Can you measure them in cc to put on an I&O sheet?

[EP10]

Wow great point. So Daily Weight it is. Is this always the case, as in, daily weight will always trump I&O when discussing the best way to track fluid balances?

[nurseprnRN, BSN, RN]

Absolutely. The standard is that you weigh the person first thing in the morning with an empty bladder before breakfast. If you have to do a bed weight, it's at the same time every day with the same number of chux, linens, etc. on the bed (but not the full Foley bag, the suction catheters, the ventilator tubings....).

Imagine a burn pt who loses quarts of fluid through his damaged skin (remember the old song..."Ya gotta have skin / To keep yer insides in.." (tune of "Ya Gotta Have Heart" from Damn Yankees).

We teach cardiac pts to do this at home every day, and to immediately report a wt gain of 2 lbs, because that's a good indication of incipient CHF (fluid retention). You should find this info in your med/surg textbook in the cardiac nursing section, but the technique is the same for looking at fluid balance in anybody.

[EP10]

I completely get that. You're a tremendous help!

Thank you!! :)

[nurseprnRN, BSN, RN]

You're very welcome. (This is why they give you that little "Like" button at the bottom of every post except your own :) )