Question about I&O

[colleen10]

Hi there,

I have a question for all of you about recording I&O.

Have you been taught in class or noticed at your clinical site if IV therapies are recorded in the patients I&O record?

I'm sure that an IV of D5W or Normal Saline would be recorded but are there any IV meds. that would be excluded from recording in the I&O?

Also, are IV therapies recorded on the patients I&O sheet or just in the nurses notes? We have I&O/vital sign sheets in every patients room but I don't think I've ever seen IV amounts listed on it. Is it not recorded on the I&O, or perhaps the person on nights at the end of the day tallys up the amt. of IV fluids for the past 24 hours and records it on the sheet.

Just wondering what all of you have experienced.

I will be keeping an eye out tomorrow to see if and where it is listed.

[BamaGirlRN]

IVPB are already calculated into the IV pump volume rate, when they are infused.

As for IV pushes, I have never considered them as part of IV intake. We have never done so, but now getting to think about it I am wondering about it. Like Mannitol for instance, I have pushed 144 ml before.

[PJMommy]

IVF should be considered as part of I/O. Typically I've seen the I/O sheets for Foley, meals, etc. with IV charting as a separate data collection. They "clear pumps" at a set time each time to determine fluids infused and then all this (I/O sheets, IVF, etc.) go into a master I/O charting system to determine whether the pt has a positive or negative fluid balance for the shift, day, etc.

[maeyken]

On our clinical I&O sheets, there was a column for intake, a column for output, and a column for IV. Made sense to me! :)

~mae

[BamaGirlRN]

Hey PJMommy, what about IV meds....that was the original question?? What do you do???

[rncopper]

If my IV meds are given thru the pump, they are already in the final "total" when I clear my pump at shifts end. Therefore, they are included.

If I give an IV med NOT on the pump, I add the amount (20, 50, or whatever is the amount of the IV med) in a separate column, mark it with whatever med it was (and I chart it at the time the med is given) and then add it for the entire I & O for the shift.

Any IV med (IV push) that I give, if it is less than 20 cc, I do not include it in the total. Unless, they are on a very strict I & O (ex - kidney tx pts who might be on replacement). Usually, those types of patients are in the ICU (maybe in a step-down unit). Floor patients usually do not need that strict of compilation of I & O's.

Just how I handle those types of situations.

[PJMommy]

Oops...sorry I missed the original question. That's what working nights will do to you. Okay...here's the answer:

- If it's a piggyback med in IV bag - then it's part of my pumps when I clear them.

- If it's a push med (or administered through syringe pump), then I chart as part of I/O tracking on PO intake, Foley, etc. If it's less than 5 cc, then I don't mess with charting unless strict I/O.

PJ

[meownsmile, BSN, RN]

If a patient doesnt have IVF running and only has an occasional IVPB,, then the IVPB volume along with the flush volume put through the pump should be recorded on the I&O sheet. As for IV push meds,, no, they wouldnt be recorded on the I&O sheet. The volume of a IV push medication is not significant to change the fluid balance, unless however you are mixing it with 50 cc's and hanging it as a infusion,, then it would also be included just as a IVPB would.