CHAP TER 21 :58 RECOR.. DIN6 INTAKE AND OUTPUT

CHAP TER 21 :58 RECOR.. DIN6 INTAKE AND OUTPUT ASSIGNMENT SHEET# 1 Grade Name INTRODUCTION: Dr. Marandez admitted Sam Jones for stomach surgery. Mr. Jones was admitted to Room 236 of Ram Hospital. After surgery, Mr. Jones was placed on I and 0. The following things occurred during the first 24 hours. INSTRUCTIONS: Using the text procedure sheet and the measurements on the metric conversion chart as references, enter the following information on an I and 0 record. Check all figures carefully. Total all8-hour and 24-hour columns. UNIT AND MEASUREMENT CONTAINER AND MEASUREMENT ( 15 drops = 1 ml 1 juice glass = 120 ml 1 teaspoon 5 ml = 1 water glass 180 ml = 1 tablespoon = 15 ml 1 large glass = 240 ml I 1 ounce = 30mL 1 coffee cup = 120 ml 1 pint = 500 ml 1 small bowl = 120 ml 1 quart = 1000 ml 1 soup bowl = 200 ml 8AM: Ate breakfast 2 cups coffee (Sanka) 5 PM: Supper 1 small bowl jello 1 glass juice 112 soup bowl broth 1 small bowl cereal 2 crackers 1 small bowl jello 6PM: Drank 1 large glass of juice loam: Used bedpan Urine 400 ml 8PM: Used bedpan Urine 480 ml 12 NOON: Ate lunch 1large glass milk 10 PM: Drank 1 glass water 1 soup bowl broth 11 PM: IV--had absorbed 750 ml since 3 PM 1 small bowl custard 2AM: Drank 1 glass water 1 small bowl jello 4AM: Used bedpan twice Urine 550 ml 1 PM: Drank 1 glass water Liquid BM 300 ml-- 2PM: Used bedpan 550 ml urine light brown 1 formed BM 6AM: Drank 1 glass water 3 PM: Drank 1 glass water IV--had absorbed 850 ml since 11 PM IV--had absorbed 800 ml since 7 AM 4PM: Vomited 550 ml dark green liquid 2009 Delmar, Cengage Learning. 469

Grade Name INTAKE AND OUTPUT RECORD Family Name First Name I Attending Physician Room No. I Hosp. No. Date INTAKE OUTPUT OTHER REMARKS TIME Oral I.V. Blood Urine Tube Emesis Feces 7-8 a.m. 8-9 a.m. 9-10 a.m. 10-11 a.m. 11-12 noon 12-1 p.m. 1-2 p.m. 2-3 p.m. 3-4 p.m. 4-5 p.m. 5-6 p.m. 6-7 p.m. 7-8 p.m. 8-9 p.m. 9-10 p.m. 10-11 p.m. 11-12 p.m. 12-1 a.m. 1-2 a.m. 2-3 a.m. 3-4 a.m. 4-5 a.m. 5-6 a.m. 6-7 a.m. 24-HOUR INTAKE OUTPUT 470 2009 Delmar, Cengage Learning.

CHA,PTER 21 :5 8 RECORD,ING INTAKE AND OUTPUT ASSIGNMENT SHEET# 2 Grade Name INTRODUCTION: Mr. Fred Wray is a patient who had bowel surgery. A catheter is in place for urine. His urinary output is measured every hour. He has an IV in place. He is allowed ice cubes and small sips of ginger ale. Otherwise he is NPO. A nasogastric tube is in place to drain stomach fluids. It is connected to a suction machine and drains into a jar. At times, the tube is irrigated so it will not clog. Mr. Wray, under the care of Dr. Pease, is in Room 2851. INSTRUCTIONS: Using the measurements on the metric conversion chart, record the following information on an I and 0 record. Total all8-hour and 24-hour columns. UNIT AND MEASUREMENT CONTAINER AND MEASUREMENT 15 drops = 1 ml 1 juice glass = 1 teaspoon = 5mL 1 water glass = 1 tablespoon = 15 ml 1 large glass = 1 ounce = 30mL 1 coffee cup = 1 pint = 500 ml 1 small bowl = 1 quart = 1000 ml 1 soup bowl = - l. Urine measured hourly: 7 AM 30 ml 7PM 40 ml 8 40 ml 8 30 ml 9 25 ml 9 25 ml 10 30 ml 10 30 ml 11 35 ml 11 10 ml 12 NOON 40 ml 12MN None 1 PM 25 ml lam 5 ml 2 25 ml 2 5 ml 3 15 ml 3 None 4 30 ml 4 10mL 5 10 ml 5 15 ml 6PM 20 ml 6AM 20 ml 120 ml 180 ml 240 ml 120 ml 120 ml 200 ml 2. The nasogastric tube was irrigated with normal saline (NS): 7 AM 20 ml 12 MN 12 NOON 30 ml 2 AM 4PM 10mL 4AM 8PM 20 ml 6AM 20 ml 10mL 10 ml 10 ml 2009 Delmar, Cengage Learning. 471

3. Nasogastric tube drainage measured: 2 PM 750 ml greenish 10 PM 990 ml greenish 6 AM 650 ml golden 4. IV intake recorded: 2 PM loooml 950mL 6AM 1050mL lopm 5. Intake in ice cubes (Note: 1 ice cube equals 5 ml) 7 AM 2 ice cubes 9 AM 1 ice cube 12 NOON 3 ice cubes 3 PM 2 ice cubes 7PM 12MN 4AM 2 ice cubes 3 ice cubes 2 ice cubes 6. Ginger ale: small sips as follows: 1 tablespoon at each of the following times: 8 AM, 11 AM, 1 PM, 5 PM, 10 PM, 1 AM, 3 AM, and 5 AM ( 7. Vomited 100 ml clear liquid at 1 PM ( 472 2009 Delmar, Cengage Learning.

Grade Name INTAKE AND OUTPUT RECORD Family Name First Name I Attending Physician Room No. I Hosp. No. Date INTAKE OUTPUT OTHER REMARKS TIME Oral I.V. Blood Urine Tube Emesis Feces 7-8 a.m. 8-9 a.m. 9-10 a.m. 1G-11 a.m. 11-12 noon 12-1 p.m. 1-2 p.m. 2-3 p.m. 3-4 p.m. 4-5 p.m. 5-6 p.m. 6-7 p.m. 7-8 p.m. 8-9 p.m. 9-10 p.m. 10-11 p.m. 11-12 p.m. 12-1 a.m. 1-2 a.m. 2-3 a.m. 3-4a.m. 4-5 a.m. 5-6 a.m. 6-7 a.m. 24-HOUR INTAKE OUTPUT 2009 Delmar, Cengage Learning. 473

CHAP TER 21 :58', RECORDING INTAKE AND OUTPUT ASSIGNMENT SHEET# 3 Grade Name INTRODUCTION: Tamika Perry, a patient of Dr. Kowalski, had a gastrectomy (removal of the stomach). A nasogastric tube is in site to drain all fluids. It is connected to suction and irrigated at times. Intake is limited to ice cubes and sips of ginger ale. INSTRUCTIONS: Using the measurements on the metric conversion chart, record the following information on an I and 0 record. Record all8-hour and 24-hour totals. UNIT AND MEASUREMENT CONTAINER AND MEASUREMENT 15 drops = 1 ml 1 juice glass = 120 ml 1 teaspoon = 5 ml 1 water glass = 180 ml 1 tablespoon = 15 ml 1 large glass = 240 ml 1 ounce = 30mL 1 coffee cup = 120 ml 1 pint = 500 ml 1 small bowl = 120 ml 1 quart = 1000 ml 1 soup bowl = 200 ml l. Nasogastric tube irrigated with normal saline (NS) as follows: 7 AM 10 ml lam loml llam 10 ml 4AM 15 ml 4PM 10 ml 9PM 15 ml 2. IV was absorbed as follows: 12 NOON 400 ml 10 PM 200 ml 2PM 150 ml 3AM 400 ml 8PM 500 ml 6AM 200 ml 3. Urine output was as follows: 9AM 400 ml 9PM 550 ml 1 PM 250 ml 1 AM 400mL 5PM 375mL SAM 200mL 4. The patient had greenish liquid stool as follows: llam 300mL 5PM 200mL 3AM 750mL 5. The nasogastric tube suction jar was emptied on each shift. Measurements are as follows: 2 PM 780 ml greenish liquid 10 PM 550 ml golden brown liquid 6AM 625 ml golden brown liquid 474 2009 Delmar, Cengage Learning.

Name 6. Water intake was as follows: (" BAM 2 tbsp 5PM 3 tbsp lpm 1 tbsp 12MN 2 tbsp 3AM 1 tbsp 7. Sips of ginger ale were taken as follows: 9AM 1 I 2 juice glass 8PM 1 ounce llam 1 I 2 large glass lam 2 ounces 6PM 1 juice glass 4AM 112 water glass 8. The patient vomited several times. Amounts as follows: 2 PM 100 ml clear liquid 9 PM 130 ml reddish brown liquid 5 AM 200 ml golden green liquid 9. Ice cubes were given as follows: (Note: 1 cube = 5 ml) 2 ice cubes at 7 AM, 12 N, 4 PM, 10 PM, and 2 AM { 2009 Delmar, Cengage Learning. 475

Grade Name INTAKE AND OUTPUT RECORD Family Name First Name I Attending Physician Room No. lhosp.no. Date INTAKE OUTPUT OTHER REMARKS TIME Oral I.V. Blood Urine Tube Emesis Feces 7-8 a.m. 8-9 a.m. 9-10 a.m. 10-11 a.m. I ~ 11-12 noon I 12-1 p.m. 1-2 p.m. 2-3 p.m. 3-4 p.m. 4-5 p.m. 5-6 p.m. 6-7 p.m. 7-8 p.m. 8-9 p.m. 9-10 p.m. 10-11 p.m. 11-12p.m. 12-1 a.m. 1-2 a.m. 2-3 a.m. 3-4 a.m. 4-5 a.m. 5-6 a.m. 6-7 a.m. 24-HOUR INTAKE OUTPUT 476 2009 Delmar, Cengage Learning.

CHAPTER 21 :58 RECORDING INTAKE AND OUTPUT ASSIGNMENT SHEET# 4 Grade Name Note: Anyone who completes this assignment correctly will not be required to do anymore I and 0 records. INTRODUCTION: Mr. John Wreckless was admitted to Room 1835 of Ram Hospital by Dr. Santoro after being in an automobile accident. After emergency surgery, Mr. Wreckless was admitted to intensive care. 1\vo IVs were infusing. A Hemovac drainage unit was in the surgical site to remove drainage. A nasogastric tube was in place and connected to suction drainage. A Foley catheter was in place to drain urine. INSTRUCTIONS: Using the measurements on the metric conversion chart, record the following information on an I and 0 record. Record all8-hour and 24-hour totals. UNIT AND MEASUREMENT 15 drops = 1 ml 1 teaspoon = 5mL 1 tablespoon = 15mL 1 ounce = 30mL 1 pint = 500 ml 1 quart = 1000 ml CONTAINER AND MEASUREMENT 1 juice glass = 120 ml 1 water glass = 180 ml 1large glass = 240 ml 1 coffee cup = 120 ml 1 small bowl = 120 ml 1 soup bowl = 200 ml 1. IV number 1 was absorbed as follows: 10 AM 1 pint blood 2 PM 500 ml saline 8 PM 100 ml saline 2. IV number 2 was absorbed as follows: 1 PM 400 ml 2AM 6AM 10 PM 1 pint plasma 200 ml saline 600 ml 6 AM 600 ml 3. The nasogastric tube was irrigated with normal saline (NS): 10 ml at 10 AM, 5 PM, 9 PM, and 4 AM 15 ml at 1 PM, 1 AM, and 5 AM 4. Nasogastric tube drainage was as stated: 2 PM 800 ml reddish brown 6AM 400 ml greenish 10 PM 750 ml golden brown 5. Meals were as follows: 8 AM Breakfast: 1 cup tea, 1/2 glass juice, and 1 small bowl broth 12 NOON 5PM Lunch: 1/2 cup tea, 1/2 soup bowl broth, and 1 small bowl jello Supper: 1 glass juice, 1 small bowl jello, and 1/2 small bowl broth 2009 Delmar, Cengage Learning. 477

6. Hemovac drainage was measured as follows: 1 PM 20 ml reddish 5 AM 9PM 15 ml pink serous 7. Ice cubes were given as follows: (Note: 1 cube= 5 ml) 1 cube at 9 AM, 1 PM, 3 PM, 7 PM, and 2 AM 2 cubes at 11 AM, 4 PM, 10 PM, and 4 AM 8. Ginger ale was given as follows: 1 juice glass at 10 AM, 2 PM, and 9 PM 1 I 2 large glass at 6 PM and 5 AM 9. Water was given as follows: 1 juice glass at 8 PM and 3 AM 1/2 water glass at 7 AM, 4 PM, and 12 MN 10. Urine drainage was as follows: 10 AM 800 ml 10 PM 940mL 2PM 600mL 2AM 850mL 11. Emesis occurred as follows: llam 200mL clear liquid 3AM 350mL greenish liquid 12. Liquid stool, light brown: 4PM 300mL 11 PM 250mL 10 ml pink serous 6AM 160mL ( ( 478 2009 Delmar, Cengage Learning.

Grade Name INTAKE AND OUTPUT RECORD Family Name First Name I Attending Physician Room No. l Hosp.No. Date INTAKE OUTPUT OTHER REMARKS TIME Oral I.V. Blood Urine Tube Emesis Feces 7-8 a.m. 8-9 a.m. 9-10 a.m. 10-11 a.m. 11-12 noon 12-1 p.m. 1-2 p.m. 2-3 p.m. 3-4 p.m. 4-5 p.m. 5-6 p.m. 6-7 p.m. 7-8 p.m. 8-9 p.m. 9-10 p.m. 10-11 p.m. 11-12p.m. 12-1 a.m. 1-2 a.m. 2-3 a.m. 3-4 a.m. 4-5 a.m. 5-6 a.m. 6-7 a.m. 24-HOUR INTAKE OUTPUT 2009 Delmar, Cengage Learning. 479

CHAPTER 21:58 RECORDING INTAKE t\nd OUTPUT ASSIGNMENT SHEET# 5 Grade Name INTRODUCTION: Maranda O'Connor, a patient of Dr. Schmidt, was admitted to intensive care at Ram Hospital with a high fever and nausea and vomiting. A nasogastric tube was inserted and connected to suction drainage. An IV was started. She was allowed clear liquids and ice cubes by mouth. INSTRUCTIONS: Using the measurements on the metric conversion chart, record the following information on an I and 0 record. Record all8-hour and 24-hour totals. UNIT AND MEASUREMENT 15 drops = 1 ml 1 teaspoon = 5 ml 1 tablespoon = 15 ml 1 ounce = 30 ml 1 pint = 500 ml 1 quart = 1000 ml CONTAINER AND MEASUREMENT 1 juice glass 1 water glass 1 large glass 1 coffee cup 1 small bowl 1 soup bowl = 120 ml = 180 ml = 240 ml = 120 ml = 120 ml = 200 ml 1. IV of 5% D /W was absorbed as follows: loam 2PM 200 ml 550 ml 8PM 10PM 450 ml 100 ml 2AM 6AM 100 ml 200 ml 2. The nasogastric tube was irrigated with normal saline CNS) as follows: loam loml 5PM 15mL 2AM 10 ml 1 PM 10mL 9 PM 10 ml 5AM 10 ml 3. Nasogastric tube drainage was measured as follows: 2 PM 550 ml greenish brown 6 AM 450 ml greenish 10 PM 200 ml golden brown 4. Meals were as follows: 8 AM Breakfast: 1 glass juice, 1/2 small bowl broth, 1 small bowl jello 12 NOON Lunch: 1 large glass juice, 1 soup bowl broth, and 2 small bowls jello 5 PM Supper: 1 glass juice, 1 soup bowl broth, and 1 small bowl jello 5. Ice cubes were given as follows: (Note: 1 ice cube = 5 ml) 1 ice cube at 9 AM, 11 AM, 3 PM, and 10 PM 2 ice cubes at 12 N, 4 PM, 12 MN, and 2 AM 3 ice cubes at 2 PM and 5 PM 6. Ginger ale as follows: 1 juice glass at 10 AM and 7 PM 1/2 water glass at l PM and 9 PM 480 2009 Delmar, Cengage Learning.

( 7. Water as follows: 1/2 water glass at 7 AM and 6 PM 1 water glass at 1 AM and 5 AM 8. Urine output was as follows: loam 400mL 10 PM 1 PM 550mL lam 5PM 400mL 4AM 9. Emesis was as follows: 9 AM 200 ml clear liquid 7 PM 300 ml brownish liquid 10. Stool was as follows: 8 AM 1 formed brown stool 7 PM 200 ml brown liquid 2 AM 300 ml brown liquid Name qs Patient incontinent 500mL 650mL ( 2009 Delmar, Cengage Learning. 481

Grade Name INTAKE AND OUTPUT RECORD Family Name First Name I Attending Physician Room No. I Hosp. No. Date INTAKE OUTPUT OTHER REMARKS TIME Oral I.V. Blood Urine Tube Emesis Feces 7-8 a.m. 8-9 a.m. 9-10 a.m. 10-11 a.m. 11-12 noon 12-1 p.m. 1-2 p.m. 2-3 p.m. 3-4 p.m. 4-5 p.m. 5-6 p.m. 6-7 p.m. I 7-8 p.m. 8-9 p.m. 9-10 p.m. 10-11 p.m. 11-12 p.m. 12-1 a.m. 1-2 a.m. 2-3 a.m. 3-4 a.m. 4-5 a.m. 5-6 a.m. 6-7 a.m. I I 24-HOUR INTAKE OUTPUT 482 2009 Delmar, Cengage Learning.