Dosage Calc, part 20: Calculating Intake & Output

Hi, this is Cathy with Level Up RN. In this video, I will show you how to calculate your patient's 24-hour fluid balance in milliliters. You can find all the information that I'll be covering in this video in our Level Up RN dosage calculation workbook. If you are in nursing school, then you know how important it is to master dosage calculations. And our workbook will help you do just that. In a nutshell, our workbook contains all the different types of dosage calculation problems that you are likely to encounter in nursing school. And we demonstrate how to solve each problem using multiple methods so you can pick the way that makes the most sense to you.

As a nurse, you often need to track your patient's intake and output so you can determine their fluid balance because knowing their fluid balance will give you valuable information about their condition. So we are going to work through a fluid balance problem. When you do these types of problems, you want to make sure you are adding up all forms of intake. So that means oral intake, IV fluid intake, IV medication intake. You want to add it all in. And then when you are recording output, you want to make sure you record all forms of output. So this includes urine output, chest tube drainage, wound drainage, that type of thing. Also, an important thing to remember is that for ice chips, you want to record that volume as half volume. So if the patient consumes a cup of iced chips, a cup is eight ounces, but you're going to record that volume as four ounces of fluid.

Okay. So let's work through the example here. We have the fluid intake for this patient for breakfast, lunch, and dinner. And then they are also receiving IV fluids at a continuous rate. So this is all their intake. And then below here, we have all their output. So their urine output, their chest tube drainage, and their wound drainage. So let's go ahead and add up their oral intake in ounces. And then we're going to convert that to milliliters because that's what we need to do for this problem. So for the oral intake, we're just going to add 8 ounces plus 4 ounces of juice plus 6 ounces of milk plus 16 ounces of water. And here we have two cups of ice chips. So two cups is normally 16 ounces, but we're going to record it as half volume, so this will be 8 ounces. And then we're going to add in that 12 ounces of diet soda. So if you add all that together, we end up with 54 ounces. But we need to take that 54 ounces and convert it into milliliters.

So we know that 30 milliliters is an ounce. That's a conversion you definitely have to remember. Our ounces will cross off here, and we'll multiply that out, and we end up with 1,620 milliliters. So that's the patient's oral intake. But they also have IV fluid intake. So for the IV fluids, those are running at 75 milliliters per hour times 24 hours. This equals 1,800 milliliters. So their total intake will be this number plus this number. So if we add these two together, we get 3,420 mL. Okay. So that's the intake part of the problem. Now we're going to work on the output. So for output, we're going to add up the urine output here. So this is how much urine was tracked throughout the day. So if we add up 700 plus 300 plus 300 plus 450 plus 420 plus 500, we end up with 2,670 mL. And then for the patient's chest tube, they have had drainage of 50, 30, and 10. So if we add that together, we get 90 mL. And then wound drainage for this patient has been 200 mL and then 100 mL. So that's 300 mL. So if we add these three things together, we end up with 3,060 mL. That is the patient's output.

So intake and output. So to determine the patient's fluid balance, we take the intake, and we subtract the output. And that equals a positive fluid balance of 360 mL. And that is the answer to this question.