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Discussion

Measuring urine output

  1. I am wondering what other units do in regards to keeping track of urine output. The Level III unit I work in does not measure urine output at all.

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  1. I am wondering what other units do in regards to keeping track of urine output. The Level III unit I work in does not measure urine output at all.

You don't measure at all? Not even counting wet diapers?? I thought measuring output was a standard of care :confused:

While our kids are on IV fluids, we weigh diapers. We aim for at least 1-2 ml/kg/hr; 3-5 is considered good. Once they are off fluids, haven't had issues with output for a while and are close to moving to level2, then they will write to just count diapers.

  • Author

Yeah, I thought it was a standard as well. We do count the wet diapers. Even with the micropremies tho, it is just a check-mark......drives me crazy

We weigh the diapers if they are on IV fluids, on oxygen, under phototherapy, or on diuretics. Otherwise we just do diaper checks.

  • Experts

@ the level 3 where I once worked, we weighed diapers up till the day of discharge! In my current level 2, we weigh diapers if they have IV fld running; everybody else gets check marks.

Not weighing is very strange to me. A drop of pee that gets a checkmark and a 50 gram diaper are a HUGE difference.

I'm a level III, every baby we have is on strict I&O.

We weigh all the diapers...every time, every patient.

My unit is the same as BabyLady's, we weigh all diapers all the time. Our micropreemies often will have orders for q 12 or q 6 hour urine output.

I am surprised at any intensive care unit that does not measure I&Os. We weigh diapers but, if we need an hourly meaurement, we will place a Foley.

Every baby here gets strict I & O with diaper weights, Level II or Level III. We are to watch overall fluid balance with each assessment and would generally like to see at least 2 ml/kg/hour.

  1. I am wondering what other units do in regards to keeping track of urine output. The Level III unit I work in does not measure urine output at all.

...and I'll add...I think that the practice of not keeping track is dangerous.

Our physicians make a huge amount of decisions based on I&O...and with a patient who is smaller and obviously cannot talk...the fact that urination or defication has taken a downslide can be your first and only clue to something that is going wrong.

Otherwise, you won't know until your baby starts showing symptoms.

Our Neo's use this to decide whether or not to advance feeds, which is evaluated q 24

Always weigh the diapers too, had a sick one the other noc and the NNP wanted my output in order to give addition fluids (bolus). It makes a difference in your lab values as well. I can't imagine not doing it. Some people are lazier about it than others, especially when they go to level 2 status.

To Dawn.... put in a foley??? Yikes!

  • Author
...and I'll add...I think that the practice of not keeping track is dangerous.

Our physicians make a huge amount of decisions based on I&O...and with a patient who is smaller and obviously cannot talk...the fact that urination or defication has taken a downslide can be your first and only clue to something that is going wrong.

Otherwise, you won't know until your baby starts showing symptoms.

Our Neo's use this to decide whether or not to advance feeds, which is evaluated q 24

you know what?? This drives me crazy as well......I don't need a lecture, I was just wondering what other units do

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