Measuring urine output

Posted
by 3yrDiploma 3yrDiploma Member

Specializes in NICU. Has 29 years experience.

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3yrDiploma

3yrDiploma

Specializes in NICU. Has 29 years experience. 49 Posts

...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

RN4Little1s

RN4Little1s

113 Posts

We'll place a foley as well if their urine output drops off or we need more specific measurements or we need to separarte urine/stool. Is that odd?

HappyBunnyNurse

HappyBunnyNurse

190 Posts

We weigh diapers on all babies until discharge. Policy states all babies with a IV should have a U bag. That doesn't always get done. However, we do keep bags on really critical babies (new admits, those in a humidified enviroments, etc). We only place Foleys in cases of urine retention.

Sweeper933

Specializes in NICU. 409 Posts

We weigh diapers on all babies until discharge. Policy states all babies with a IV should have a U bag. That doesn't always get done. However, we do keep bags on really critical babies (new admits, those in a humidified enviroments, etc). We only place Foleys in cases of urine retention.

How do you deal with skin integrity and all of that stuff on kids with long term IVs...??? I can't imagine having to put a bag on a kid for more than a few times in a row, let along days / weeks!!!

HappyBunnyNurse

HappyBunnyNurse

190 Posts

Our head neo is sort of obsessed with urine output (perhaps rightly so). That said, we wash the area with soap and water (just sterile water for the tiny ones), dry completly, then stick the bag. We let them wear it until it leaks really bad. If it is put on right then it can last a good 12 hours. We also do RUAs once a shift on all babies who are on IV nutrition. I have only seen one baby with breakdown from a u bag and she was a 23 wkr who had breakdown everywhere right before she passed (leads, IV site, temp probe... so sad). The preemie bags have flexable adhesive tabs. I really hate the bigger ones.

Edited by HappyBunnyNurse

prmenrs, RN

Specializes in NICU, Infection Control. Has 42 years experience. 4,565 Posts

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

I can see where it would. I think many posters are trying to give you "ammunition" to help you get practice changed in your unit.

I think it's fair to say that the "community Standard of Care" nationwide (and further) is to weigh diapers/measure output.

I hope that helps you. Good Luck. Unless the leadership in your unit, both medical and nursing, decides the info is needed, you really have an uphill battle. Start @ the top, and keep working to provide good care.

nicu4me

nicu4me

121 Posts

Our ER needed a foley for a few month old baby and we didn't even stock them small enough. What fr.size do you use? We don't use diapers on anything smaller than 1000 grams, we have no wee pees we use ob sponges (the felt things) and make a sumo (sp?) style diaper. Each weighs 2 grams without pee. And we are a lg level 2. Preemie diapers on little babies drives me nuts, especially with the hips and not to mention they are so tall up the back it covers the temp probes. Some try to make their own using mole tape and cut the preemie but think of the variability on the weight of those depending upon who makes them up during their shift, I don't do it.

Sweeper933

Specializes in NICU. 409 Posts

We will use a 5fr feeding tube as a catheter on our babies. Works pretty well. But we have to make sure to use the old style ones - the ones that connect to both feeding tubes and IV syringes, not our new orange feeding syringe only ones. This way, we just connect the end of the feeding tube up to the rest of a normal foley set-up.

Mimi2RN

Mimi2RN, ASN, RN

Specializes in NICU. Has 27 years experience. 1,142 Posts

We weigh diapers clear through to couplet care before discharge. I agree, it's Standard of Care. The Neo's always want the last 24 hours output for the next days intake.

We rarely do foley catheters, but we haven't use 5 fr og's since one got tied in a knot inside the the baby, and couldn't be withdrawn. Now we have a stack of Foley catheters that will expire before they are used. We have maybe one baby a year that needs a foley!

RM-RN

RM-RN

Specializes in NICU. 18 Posts

For us, strict I/O is the standard on admit. We'll continue it by order for anyone NPO, with cardiac/renal/glucose issues, or really any baby who might remotely need it. Once the baby is stable, we might continue doing it just because the nurses think it's a good idea. :) Every baby still has their number of voids and stools counted.

We do have Foleys in 3.5 and 5fr, but we rarely use them. If anything, we end up sending them to the ER since they don't stock them.

Florida NICU RN

Florida NICU RN

Specializes in Neonatal. 32 Posts

I work in a Level III NICU and we record the urine output with all diapers. Doesn't matter if it's a 22 weeker or 40+ weeker.

karnicurnc

karnicurnc

Specializes in L/D 4 yrs & Level 3 NICU 15 yrs. Has 19 years experience. 173 Posts

We measure urine output for the first 24 hours on all admissions. After that we just do diaper checks, unless there is a renal issue. We also do strict I/O when we start certain meds like dopamine, neoprofen and steroids. We place a Foley if there are complications with output.

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