Question

Mr Tsiamis is placed upon a 24 hour Fluid Balance monitoring. Explain what this entails and what information it can provide to the treating team.

Answer 1

MONITORING FLUID BALANCE

• Monitoring of fluid balance is required for people with renal failure, electrolyte imbalance, or severe vomiting and diarrhea.
• I t is also necessary for people with nasogastric tubes and drainage collection devices.
• In addition, those receiiving intravenous therapy and those taking medicines such as diuretics and corticosteroids also need to have their fluid balance monitored
• These measurements are important to help evaluate a persont fluid and electrolyte balance, to suggest various diagnosis and allows for prompt intervention to correct the imbalance.
• Records of all intake and output must be kept meticulously in an intake and output chart(I/O chart)
• All amounts must be measured and record in milliliters.
• Do not estimate the amount
• If the person is able to cooperate, he should be encouraged to help in keeping an accurate record of his daily fluid intake and output.
• At the end of 24 hours period, add up the total intake and output.
• Evaluate the person's fluid status in relation to the disease process, medication regimen, diet and activity ordered by the health care professionals
• The person is said to be in negative fluid balance if his output is greater than his intake
• Conversely , a positive fluid balance occurs when intake is greater than output.

FLUID INTAKE

• Fluid intake refers to all fluid entering the person's body. It also includes foods that are liquid at room temperature such as ice chips, ice cream and certain beverages.

FLUID OUTPUT

• Fluid output refers to all fluids that leaves the person's body. This includes urine, loose stools, vomitus,aspirated fluid, excessive perspiration and drainage from surgical drains, nasogastric tubes and chest tubes

DEHYDRATION

Dehydration can be defined as the excessive loss of water from the body. It can be caused by losing too much flluid ( as in vomiting and diarrhea) not drinking enough water or both

Signs of dehydration includes:

• Flushed and dry skin
• Dry lip
• Dry and furred tongue
• Increasing thirst
• Low or no urine output
• Concentrated urine appears dark yellow
• Sunken eyeballs
• Sunken fontanelles
• Increase breathing and heart rate
• Low blood pressure causing lightheadedness
• Delayed capillary refill
• Poor skin turgor
• Shock
• Delirium or unconsciousness in most serious cases