Calculating Intake and Output

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Hello. I was wondering if anyone could help me solve intake and output problems. I found two online and have been trying to solve them, but I don't understand what I am doing wrong. I posted my work below. Thanks.

Calculate the patients INTAKE during your 12-hour shift:

0800: Two pieces of toast, 2 cups of oatmeal, 8 oz yogurt, 12 oz orange juice, 2 oz grits—

1000: Two 8 oz of coffee w/ 2 oz of cream in each—

1100: 24 oz of ice chips—

1200: IV infusion of Zosyn 50 mL, 2 mL IV push Zofran and 10 cc saline IV flush—

1230: house salad, 12 oz soda, three 12 oz popsicles—

1400: One pack of red blood cells (250 mL)—

1500: 2 mL Morphine and 10 cc saline flush IV—

1715: 10 cc saline flush IV—

1600-1900: Normal Saline IV 100 cc/hr

A.  2390 mL

B.  2124 mL

C.  3394 mL

D. 3294 mL

My Work:

12 + 8+8+2+2+(24/2)+12+(12*3)=92*30=2760

50+2+10+250+2+10+10+(100*12)=1,534

1534+2760=4294 total

Problem 2

Estimate the patients 8 hour (3pm-11pm) intake:

IVF @ 25cc/hr continuous

TPN @ 50cc/hr continuous

Lipids at 10cc/hr for 12 hours (8pm-8am)

NGT feeds @ 25 cc/hr continuous

2 units of blood – 250ml/unit – first unit at 10am/ second unit at 4pm

IV Vancomycin – 250ml every 12 hours at 8am/8pm

My Work:

(25*8)+(50*8)+(10*12)+(25*8)=920

250+250=500

920+500=1,420

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I’m having some difficulty following your work for the first problem.  When I work this type of problem, I lay it out in the following format, and only include the items I need to count:

    0800: 12 oz orange juice.  12 * 30 = 360
    1000: Two 8 oz of coffee w/ 2 oz of cream in each.  20 * 30 = 600
    1100: 24 oz of ice chips.  24 * 30 = 720

This allows me to better track what my calculations.  Having said that, I don’t get an answer close to the ones provides, and calculation is nearly 700 mL less than yours.

For the second problem, how many hours of the lipid infusion should you be including?

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Chare, I just use 12 hours for the lipid infusion, but I am not sure. I am not entirely sure how to solve problems involving IVs, other than simple ones. My instructor just said to learn intake and output online, so I am just trying to gather information where I can. Thanks for your help.

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7 hours ago, lexieanders said:

12 + 8+8+2+2+(24/2)+12+(12*3)=92*30=2760

50+2+10+250+2+10+10+(100*12)=1,534

1534+2760=4294 total

- Wouldn't be surprised if the popsicles are less than oz listed, kind of like ice chips.

- You wouldn't do 100 * 12 for the NS; they told you it was only running for 3 hrs.; = 300.

That said, with those adjustments I get 2854 ml, which still isn't one of their choices.

Surely they don't want you to account for liquids used to hydrate grains like oatmeal and grits; that would be a little out in the weeds unless that were a facility's policy and the exact amount used were provided by dietary services. Too bad they don't give a rationale for their answer.

***

#2 -

Agree, check the lipids.

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I think I figured out the first one.

oz: 12+16+4+12+12+12+12+12=92x30=2760

ml: 50+2+10+250+2+10+10+300=634

2220+634=3394

Thanks for everyone’s help. I will keep trying to determine the second solution.

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I checked out the lipids and figured out the second answer. So, the lipids should run for 3 hours based on the shift time of 3pm-11pm. My mistake was that I wasn’t calculating based on what would be infused during the given shift time.
200+400+30+200+250+250=1330

Again, I appreciate everyone’s help!

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Specializes in Wiping tears.
On 6/10/2021 at 2:11 PM, lexieanders said:

Hello. I was wondering if anyone could help me solve intake and output problems. I found two online and have been trying to solve them, but I don't understand what I am doing wrong. I posted my work below. I am not sure why I wasn't able to submit my other post, so I created a new topic. Thanks.

Calculate the patients INTAKE during your 12-hour shift:

0800: Two pieces of toast, 2 cups of oatmeal, 8 oz yogurt, 12 oz orange juice, 2 oz grits—

1000: Two 8 oz of coffee w/ 2 oz of cream in each—

1100: 24 oz of ice chips—

1200: IV infusion of Zosyn 50 mL, 2 mL IV push Zofran and 10 cc saline IV flush—

1230: house salad, 12 oz soda, three 12 oz popsicles—

1400: One pack of red blood cells (250 mL)—

1500: 2 mL Morphine and 10 cc saline flush IV—

1715: 10 cc saline flush IV—

1600-1900: Normal Saline IV 100 cc/hr

A.  2390 mL

B.  2124 mL

C.  3394 mL

D. 3294 mL

My Work:

12 + 8+8+2+2+(24/2)+12+(12*3)=92*30=2760

50+2+10+250+2+10+10+(100*12)=1,534

1534+2760=4294 total

Problem 2

Estimate the patients 8 hour (3pm-11pm) intake:

IVF @ 25cc/hr continuous

TPN @ 50cc/hr continuous

Lipids at 10cc/hr for 12 hours (8pm-8am)

NGT feeds @ 25 cc/hr continuous

2 units of blood – 250ml/unit – first unit at 10am/ second unit at 4pm

IV Vancomycin – 250ml every 12 hours at 8am/8pm

My Work:

(25*8)+(50*8)+(10*12)+(25*8)=920

250+250=500

920+500=1,420

Do you know how to use MS Excel? Try to learn how to utilize it. It's quicker if you know how to manipulate the spreadsheet. 

I utilized in the past in medical billing. 

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Specializes in Psyche Nursing, Med/Surg, LTAC.

I noticed in the first problem it only gives the IV fluid as running at 100 cc/hr from 1600-1900. So it would be 100 x 3 hours, not 100 x 12. 

 ( In real-life nursing, of course, it would probably run all day...)

The second problem is tricky-it is asking for the 8 hour intake ONLY between 3 pm to 11 pm. So you would only count the lipids from 8 pm-11pm. Anything not between 3-11 doesn't count. 

I hated medical math. The best advice I can give you is read each question at least 2 times and look for tricky details. 

Good luck and may the Force be with you!

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Specializes in Physiology, CM, consulting, nsg edu, LNC, COB.

My advice on these types of questions is always to read them twice and pay particular attention to the question being asked before getting entangled in the details. These are less calculation exercises than judgment— they want to know what you know, not whether you can add. 

In this case, you’re being asked to add up fluids, so ignore the toast, salad, and other stuff that isn’t liquid content. In some places, lipids and blood count as fluids for purposes of I&O, and in some, they don’t, so refer to your syllabus on that one before adding them in.

Notice that although you might be given info on a 24 hour or 12 hour time frame, the question asked might be referring only to part of that, like three hours only, not all 12 or 24.

Also notice different units, such as ozs and cc, and repeated bits, like q4h.

Again, this is looking for your ability to decide and observe, not just to add.

Write down the things to include, then add up. 

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Specializes in Cardiac.

Clear the pump and write down what it says. Include the channels that are no longer running (lipids) Estimate the volume that you may have flushed Ivs with. Trust that your CNA correctly entered the oral intake, the 3 emesis episodes, 2 liquid stools and 3 “missed the hat” voids. Question if it doesn’t make sense. Who takes credit for creamer and IV push morphine? Other than CRRT you would enter oral intake in the moment and clear pumps at the 8 hr end of shift and enter. Then click on the I/O tab to see what the computer calculated for you. Did  you want to see it as a graph or in a table? Oh my…. That was the 3rd liquid stool so put up the isolation caddy for cdiff ! 
I think they forgot to tell you that the family gave your CHFer 3 cups of water from the tap, and now has crackles 1/2 way up, has a RR of 32 sats  of 86% and you called a rapid response. RT is currently grabbing BiPAP  and you are going to transfer the pt upstairs….

Sorry, this just isn’t real life—so I hope a little humor helps. Besides I never have seen a 12 oz popsicle much less 2 of them!  I get that they want you to convert oz to mls and then add together… 

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Specializes in ICU/Burn ICU/MSICU/NeuroICU.

Our lives (your problems) would be so much easier to figure if we all said 'yes' to the metric system. The USA uses a half-assed system for medical math. oz and mL? really? Dumb!

 

Covert all your stuff to metric and figure away. 

When you get bedside you'll thank yourself for doing so.

Imagine. Mr. litepath sweats, urinates and stools all day in his bed. End of shift you see you've given him about 2000mL of fluids during the shift. But his output was impossible to measure since it went into the bedsheets. But you had a trick up your sleeve and you took time to weigh his sheets before making the bed and after each soiling did the same and weighed the fouled linens as well. The weighted measurements were in kg, and the difference in before and after weights in kg are his outputs. Those kg = L. 

My cohorts for the most part despised the metric system. But for me, it was a godsend.

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