I & O

I know this has probably been addressed.....but I am confused about I&O' during the CPNE.I test in less than 3 weeks and this is the thing that has me stumped. Do you only measure if they eat/drink while you are there or what? I know that you measure IV fluids if they finish and you hang another bag (I think that is right). What about flushes, IVP and IVPB? And one more thing, when you hang a new IV bag, do you spikeit while on the pole or invert and spike? I appreciate any advice. I think I am getting a little stressed (LOL).Thanks-Terri

I&O

Only measure what is consumed during your time in the room. Only what they drink, NO food. Yes, only measure the bag of IV fluids if it finishes while you are in the room. You will not give any IVP medications, but you might flush an IVAD, and yes, since the entire 3cc or 5cc will go in while you are in the room you would record that. If the IVPB infused entirely while you are in the room there is a space for that on the PCS form, I think it is left bottom corner, but that box & the flush for the IVAD would be added to the entire amount under parenteral fluids at the top, I think it is the left hand side top box. IV bag has to be inverted, it is almost impossible to spike upwards, and you run the risk of it leaking. The rule of thumb for I&O's is if its liquid and goes in the mouth note the amount. Parenteral (IV fluids) IF it FINISHES while you are in the room, not documenting then you would count that. Good luck

Thanks so much. You clarified a lot for me. I think I am beginning to over think everything. I just don't want to fail over something simple. I was pretty sure about spiking the bag but somewhere I thought I saw that you could not invert the bag. Probably dreamed it ( or had nightmares). Thanks again.:)

I have spiked both ways MANY times, doesn't really matter it can be done either way.......HOWEVER you HAVE to take down the finished bag that was already spiked to unspike it.If you pull out the spike with it hanging upside down any fluids in it will fall all over the floor. However I would guess to say every nurse here has done that at least once or twice either in the beginning of their career or even just when in a hurry or distracted! So if if happens just know you are not alone. No big deal. If switching something like a continuous saline fluid I go in and hang up the new bag-already labled with date time your initials and the exact ordered fliud and rate, and if a specific number of bags/liters ordered I will get that many bags and label all of them (ie 1 of 4, 2 of 4, 3 of 4 and 4 of 4), take down the old bag and pull out the spike and then pull of the cover tab thing on the new bag and spike quickly as to lessen the amount of time the spike is exposed. If I spike with the bag up I have less problems with air. Then give a squeeze to the drip chamber till half full. When you get report that a patient is on fluids from the prior nurse I suggest though that you look at the order..the most current...written by the doc....not the one taken off onto a cardex and check the running bag to be sure it is the right fluid. I have found on more then one occasion that the prior nurse either says one fluid and hung another (ie half NS/0.45% is ordered and NS/0.9% saline is hanging)...either because the nurse grabbed and hung the wrong solution by accident or the order changed mid shift to a lower sodium level after labs showed a high Na+ and the change was never made with the running fluid. This can be detrimental especially if this is with a bag with potassium and it was switched back to NS after a high K+. So look for yourself at the order and the bag.....The other thing is you might want to find out how your hospital does the counting of fluids for each shift on I&O. The way the nurse in the last posted...I have done it like that at one hospital/unit. But different at another......at one we counted what when in from the bag hanging even if it wasn't finished on your shift. so you might see the on your shift you finished the last 300 from a bag, got another 1L/1000cc and you started a new bag and 250 went in from that one. We also count jello as a liquid, especially if you have someone consuming a lot of them! Check with your specific hospital--I have learned I&O may be done just a bit different in each place......

Do not go by hospital policy during the CPNE- go strictly by the CPNE study guide.

Remember to not think of this as you would do at your work. This is a test so follow what TLAandy posted. You are not the primary nurse so don't do anything extra only what you are assigned. If you do any extra you could run out of time. They say that if it is close to running out it will state on the Kardex something like 100mls left in IV bag as a cue that you will need to hang a new one while you are in there. The CE's will have already spoken with the primary nurse so you shouldn't be thrown a curve ball.

Now, go in there confident and find a way to relax because you have studied and you know this stuff!!!

I know this has probably been addressed.....but I am confused about I&O' during the CPNE.I test in less than 3 weeks and this is the thing that has me stumped. Do you only measure if they eat/drink while you are there or what? I know that you measure IV fluids if they finish and you hang another bag (I think that is right). What about flushes, IVP and IVPB? And one more thing, when you hang a new IV bag, do you spikeit while on the pole or invert and spike? I appreciate any advice. I think I am getting a little stressed (LOL).Thanks-Terri

Only measure what they eat or drink while you are there. Example: they have a breakfast tray there, count that in your I&O. Be sure you count any IVP or IVPB. If you hang a new IV bag I think either way is ok. I left it on the pole. Just make sure you are following the study guide and you'll be ok.

hey terri!

just wanted to wish you luck! you can do it!!

:tbsk: relax...

~~~~~~

melissa

Thanks Melissa... the closer it gets (only 2 weeks :scrm: ) the more nervous I am