Directions: Using the following scenarios and information, record the correct amounts for both fluid intake and output on the I&O Record sheet. Convert all amounts to ml. Complete each shift total and 24 hour totals.
Scenario 1: You are the CNA on the day shift and agree to work a double-staying to work the PM shift. You are assigned to care for resident. Mr. C, with an I&O order. Record the following:
DAY SHIFT: 7am Voided 300mL urine. 8am Breakfast: Mr. C. ate scrambled eggs, toast and jelly, 4 oz. orange juice, and a 240ml. mug of coffee
. 9:30am Mr. C. had a large formed B.M. and voided 200mL of amber urine.
10:30am He drank two 6 oz. glasses of water. 12noon He voided 150mL of urine. Lunch: Mr. C. ate 1/2 turkey sandwich, 4 oz. cranberry juice, 8 oz. lemon-lime soda, 3 oz. gelatin, and a bag of chips. 2pm He drank a 6 oz. glass of water. He voided 150mL of urine. PM SHIFT: 3pm Mr. C drank 4oz of apple juice and ate half of 120ml ice cream
. 4:30pm He voided 200ml. 6pm Dinner: Mr. C.ate 100% of the 4oz chicken breast, mashed potatoes, green beans, 240ml milk, 1 slice of chocolate cake, and 240mL of decaf coffee.
7pm Voided 200mL.
9pm HS snack: He ate some cheese and crackers, and he drank two 4 oz. apple juices. 10pm Mr. C. vomited 100mls. of liquid emesis. Voided 200ml.
NIGHT SHIFT:
lam Vomited 100mL and voided 100mL. 6am Voided 100mL. *Record all totals for the three shifts, and complete the 24 hour total for both INTAKE and
OUTPUT.
Scenario 2: The patient is on day 1 post-operatively and has an order for “diet as tolerated.” The progression of diets in this scenario is typical of a post-op patient. For this scenario complete the following:
- Record the I&O on the Intake and Output sheet.
- Name the diet being served for each meal.
0800 Breakfast: 4oz. apple juice, 240mL chicken broth, 3oz gelatin, 1/2 of a 6oz. cup of tea.
Name of BREAKFAST DIET:
0900 Small soft BM and voided 300mL of amber urine 1100 Voided 250ml. Drank 4oz of water.
1200 Lunch: 180mL of cream of tomato soup, 3oz. of vanilla ice cream, 6oz. coffee c cream. Name of LUNCH DIET:
1300 voided 250mL.
1400 Voided 250ml. Drank 6oz. of water. The surgical Hemovac drain was emptied of 60ml. of bloody fluid.
1500 Ate 2 packages of low-sodium saltine crackers, two 4oz. cranberry juice cocktails
. 1700 Voided 400mL. 1800 Dinner*
The Correct Answer and Explanation is :
Scenario 1: I&O Record for Mr. C (Day Shift, PM Shift, and Night Shift)
DAY SHIFT:
- 7:00am: Voided 300 mL urine
- 8:00am (Breakfast):
- Scrambled eggs, toast, jelly
- 4 oz. orange juice = 120 mL
- 240 mL coffee = 240 mL
- Total intake for breakfast = 120 mL + 240 mL = 360 mL
- 9:30am: Voided 200 mL urine
- 10:30am: Drank two 6 oz. glasses of water = 2 × 180 mL = 360 mL
- 12:00pm (Lunch):
- 1/2 turkey sandwich
- 4 oz. cranberry juice = 120 mL
- 8 oz. lemon-lime soda = 240 mL
- 3 oz. gelatin = 90 mL
- Total intake for lunch = 120 mL + 240 mL + 90 mL = 450 mL
- 2:00pm: Drank 6 oz. water = 180 mL
- 2:00pm: Voided 150 mL urine
PM SHIFT:
- 3:00pm: Drank 4 oz. apple juice = 120 mL, ate 60 mL ice cream (half of 120mL)
- Total intake for 3:00pm = 120 mL + 60 mL = 180 mL
- 4:30pm: Voided 200 mL urine
- 6:00pm (Dinner):
- 4 oz. chicken breast
- Mashed potatoes
- Green beans
- 240 mL milk
- 1 slice chocolate cake
- 240 mL decaf coffee
- Total intake for dinner = 240 mL + 240 mL = 480 mL
- 7:00pm: Voided 200 mL urine
- 9:00pm (HS Snack):
- Cheese and crackers
- Two 4 oz. apple juices = 2 × 120 mL = 240 mL
- Total intake for snack = 240 mL
- 10:00pm: Vomited 100 mL liquid emesis, voided 200 mL urine.
NIGHT SHIFT:
- 1:00am: Vomited 100 mL liquid emesis, voided 100 mL urine
- 6:00am: Voided 100 mL urine
24-HOUR TOTALS:
INTAKE (in mL):
- Breakfast: 360 mL
- Lunch: 450 mL
- Dinner: 480 mL
- Snacks: 240 mL
- Drinks: 360 mL + 180 mL + 120 mL + 180 mL + 240 mL = 1080 mL
TOTAL INTAKE = 360 mL + 450 mL + 480 mL + 240 mL + 1080 mL = 2610 mL
OUTPUT (in mL):
- Urine (Day Shift): 300 mL + 200 mL + 150 mL = 650 mL
- Urine (PM Shift): 200 mL + 150 mL + 200 mL = 550 mL
- Urine (Night Shift): 100 mL + 100 mL = 200 mL
- Vomit: 100 mL (PM Shift) + 100 mL (Night Shift) = 200 mL
TOTAL OUTPUT = 650 mL + 550 mL + 200 mL + 200 mL = 1600 mL
Scenario 2: Post-operative Patient
DIETARY INTAKES AND OUTPUTS:
- 8:00am (Breakfast):
- 4 oz. apple juice = 120 mL
- 240 mL chicken broth
- 3 oz. gelatin = 90 mL
- 1/2 of 6 oz tea = 90 mL
- Total Intake = 120 mL + 240 mL + 90 mL + 90 mL = 540 mL
- 9:00am: Small soft BM and voided 300 mL amber urine
- 11:00am: Voided 250 mL urine, drank 4 oz. of water = 120 mL
- 12:00pm (Lunch):
- 180 mL cream of tomato soup
- 3 oz vanilla ice cream = 90 mL
- 6 oz coffee with cream = 180 mL
- Total Intake for lunch = 180 mL + 90 mL + 180 mL = 450 mL
- 1:00pm: Voided 250 mL urine
- 2:00pm: Voided 250 mL urine, drank 6 oz water = 180 mL, surgical Hemovac drain = 60 mL
- 3:00pm: Ate 2 packages saltine crackers, 2 × 4 oz cranberry juice = 240 mL
- 5:00pm: Voided 400 mL urine
- 6:00pm (Dinner): (Details not included in image)
DIET TYPES:
- Breakfast Diet: Clear Liquids (apple juice, tea, broth, gelatin)
- Lunch Diet: Full Liquids (cream soup, ice cream, coffee with cream)
Explanation:
For both scenarios, the I&O (Intake and Output) record tracks all fluids the patient consumes and excretes, including drinks, meals, and any bodily outputs like urine, vomit, or drainage from medical devices. The fluid intake is recorded in milliliters (mL), as are the fluid losses (urine, vomit). Each shift’s totals are calculated based on the time of day, and the 24-hour total provides an overview of the patient’s fluid balance. This helps healthcare providers ensure the patient is maintaining proper hydration levels and detect any concerns with fluid retention or loss.
In Scenario 1, Mr. C’s daily intake and output are recorded, and totals are calculated by adding up the amounts for each shift. Similarly, in Scenario 2, the post-operative patient’s fluid intake and output are carefully recorded to ensure proper recovery after surgery, using specific diets suitable for the patient’s condition. Proper management of fluid intake is crucial in preventing complications such as dehydration or overhydration, especially in vulnerable populations like post-surgical patients.