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I&O

LTC Directors   (1,099 Views 5 Comments)
by CapeCodMermaid CapeCodMermaid, RN (Member) Member Nurse

CapeCodMermaid has 30 years experience as a RN and specializes in Gerontology, Med surg, Home Health.

1 Follower; 60,301 Profile Views; 6,072 Posts

When do all y'all put someone on I&O? It's been my practice to limit I&O to someone NEWLY given a foley catheter or on a fluid restriction. Otherwise it's better to do a dehydration risk assessment or a fluid overload assessment.

We having discussions here...one nurse is adamant that anyone with a foley has to be on output and another adamant that someone with a gtube has to be on intake.

I call BS.

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57 Posts; 1,684 Profile Views

Our CNAs document foley output q shift. Nurses document exactly what they put into a tube feed, be it water or feed. So I never thought about it much but I guess we technically record everythiiiiing.

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CoffeeRTC has 25 years experience as a BSN, RN.

3,730 Posts; 21,668 Profile Views

I haven't seen strick i/o in years. If someone is on a fluid restriction we record that. A new foley would get closer monitoring. In my experience, it is rarely done right anyway.

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Agree with Coffee that it is rarely accurate, in my last facility every new admit got I&O for the first 72 hours, every CHF patient stayed on it the whole time they were there, anyone on a fluid restriction or with s/sx dehydration or elevated kidney function labs, it was ridiculous. And all it takes is one person who forgot they refilled the water pitcher or emptied the urinal to screw it up for the day. Ratios are too high for this to get done well, as well as patients having family members bring in outside fluids or some staff counting drinks they brought in regardless of if they got thrown away...

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Tenebrae has 7 years experience as a BSN, RN and specializes in Primary Health, Gerontology, Palliative.

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My question would be what is going to be done with the information?

If its collecting information to allow nursing and med staff to plan care, usually it should be time limited. If I have someone whose lost alot of weight, or appears to not be eating then I'll impliment I & O for a set period of time, which gives us information to give to the doctor and dietican

If its gathering information without a clear clinical reason then no, I wouldnt

Looking at a foley output, I'd be more concerned with the output its self, what colour, clarity, is there any debris or blood? Urine colour indicates fluid intake. If its dark and sludgy chances are they arent taking in enough fluids

As for a Gtube or similar, chances are if they are on a set feeding regime, then you know how much they are going to be taking in. I recall a patient who was on a continuous feed overnight (1000mls) and had 200ml top ups at breakfast, lunch and tea. We knew that they took in 1600mls every day. I've had another patient who was a bit more lienent with their intake, eg would have 2-3 coffees as well as their continuous feed throughout the day but even so we had a fairly consistent idea of how much they were taking in throughout a 24 hour period

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