Hi, this is Cathy with Level Up RN. In this video, I will explain how to calculate a pediatric 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 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.
Let's now talk about calculating the intake and output for a pediatric patient. It works in much the same way as we did with adults. We want to make sure we are considering all forms of intake, so oral intake, IV fluid, and IV medication intake, and we want to make sure we're considering all forms of output. So this includes urine output, wound drainage, chest tube drainage, as well as emesis. With the pediatric population, however, infants and small children may be wearing diapers. So in order to calculate their urine output, we would take the wet diaper weight and subtract out the dry diaper weight, and that would give us the grams of urine output, and 1 gram is equal to 1 milliliter of urine output.
So let's work through our example problem here. During the nurse's 12-hour shift, the infant drinks eight ounces of formula, vomits 30 mls, so that's their emesis, and voids three times. The infant's dry diaper weight is 25 grams. Their first wet diaper weighed 80 grams, the second weighed 95 grams, and the third weighed 100 grams. Our first question is asking us to calculate the infant's intake in milliliters. So with this scenario, the only thing we are given as far as intake is the fact that the infant drank eight ounces of formula. So we need to convert that eight ounces to milliliters. So for part A, we would take eight ounces and multiply times the appropriate conversion factor. So this is something you definitely need to remember, is that there are 30 mls in an ounce. So if I calculate this out, I end up with 240 mls, and that is the infant's intake. So that part was easy enough.
So part B asks us to calculate the infant's output in milliliters. So for the infant's output, we have three wet diapers we need to figure out, and then we need to make sure we are counting the emesis of 30 milliliters. Let's first work out the urine output. So our first wet diaper weighed 80 grams, and our dry diaper weight was 25 grams. So if I take this, I end up with 55 grams. Our second diaper weighed 95 grams. And if I subtract out our 25 grams, I end up with 70 grams for that second diaper. And then our third diaper was 100 grams. So 100 minus 25 equals 75 grams. So if I add all this up together, that's 200 grams of urine output, and like I shared earlier, 1 gram equals 1 ml. So this 200 grams becomes 200 mls of urine output. But remember, to calculate the infant's total output, we've got to also add in this emesis. So 200 plus that 30 equals 230 mls of output. So that is the answer to part B. Then in part C, it asks us, what is the infant's fluid balance? So if I take 240 mls, that's the infant's intake, subtract out the output, which was 230 mls, I end up with a positive fluid balance of 10 mls, and that is the answer to part C of this problem.
