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Help with I & O

Cardiac   (1,636 Views 4 Comments)
by RN ColbyJack RN ColbyJack (Member)

RN ColbyJack has 4 years experience and specializes in Cardiovascular.

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My unit is notoriously poor at measuring and recording I & O. We take care of a lot of folks with CHF and those post CABG. I frequently find myself at the end of the shift with incomplete I & O recorded. Anyone have any helpful hints for getting better I & Os?

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madwife2002 has 26 years experience as a BSN, RN and specializes in RN, BSN, CHDN.

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We have the same problem, I have nursed for 17yrs and the only place it was done nearly 100% correctly was a renal floor where you watched your pt's fluid intake like a hawk.

A suggestion would be for the pts who are able to you could get them to write down what they drink as a lot of them are able to do this or get a check list and they check it when they have had a drink. The only ones who would cheat are the ones on a fluid restriction.

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LanaBanana specializes in Level III cardiac/telemetry.

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We have I&O sheets that are either taped somewhere inside each room or placed in the nurse-server ( a little closet at the door that has access from inside and outside the room.) Anybody who empties a pottyhat or urinal is supposed to write it down on those and I think most people are pretty compliant with that. As for intake, on pts who are strict I&O (but not fluid restriction), I have sometimes given them several cups that have measurements on them and a black marker. Every time they fill up a cup I ask them to mark how high it was filled and then use a different cup next time. Sometimes that works, other times not. You can also go by their water pitcher.

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I'll bring them a hat and chat about I&O and our charting needs before they transition from foley/urinal to BSC or BR. Most are willing to use the urinal to assist in measurement even after they're OOB. The other thing is I do my own I&O. If they're on Lasix I give them 2 urinals. I'm checking to empty the urinal hourly, and I take the trays away myself. They're all pretty good about remembering intake after I explain that I'll be asking them. I never rush them because they rarely recollect accurately unless given a little time to think it over. I can't worry about other shifts, except if I find urine in the room at start of shift, I ask when they filled it, and also I ask about last BM. Also if I can't put it on the flowsheet because it's not at hand, I'll add the time to the quantity I record on the wall sheet. I have to see the urine myself to check for cloudiness. I don't think I'll ever be through working on how I handle I&O.

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