When measuring intake and output you may need to convert ounces to milliliters?

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  • To maintain adequate health, we need to take in a certain amount of fluid per day. Depending on a patient’s condition, they may either be encouraged to drink fluids or limit their fluid intake. Fluid that is taken in is called intake. Fluids are usually measured using milliliters (mL). One cup of liquid is 8 ounces or 240 mL.

    The amount of food that is eaten can also be measured. This can be done by weighing the food prior to serving and subtracting the amount left to get the total intake. Food intake can also be measured by determining percentage eaten. If all the meal is consumed, the intake is 100%. If none of the meal is consumed, the intake is 0%. A quarter of the meal consumed would be 25% and half the meal consumed would be 50%. The agency will specify the unit of measurement to be used.

    1. Explain to the patient the importance of recording their intake. Throughout your shift, ask the patient what and how much they have had to eat or drink.
    2. During food preparation, measure the amount of food or liquid that is served. Use standard measuring cups and spoons to properly measure intake. Record this in the appropriate place.
    3. Once the patient has finished eating or drinking, subtract the amount they have consumed from the amount you served. Record this number as their input. Input for fluid should be recorded as milliliters (mL).
    4. Record the weight or percentage of food consumed in the appropriate place.
    5. Document all intake. The agency may provide Home Health Aides/Personal Care Aides with a specific intake and output (I & O) sheet. They should report any observations or changes in condition or behavior.

    Intake and output calculation NCLEX review for nurses. This quick review will highlight how to calculate intake and output because these type of questions may be on your NCLEX exam or (definitely) on a nursing lecture exam.

    It seems like calculating I and O’s is self-explanatory, right?! Well, it can be tricky, especially calculating intake because many students get confused on what to include, how to convert from ounces to milliliters, and how to interpret the calculation.

    Don’t forget to take the intake and output practice calculation quiz after reviewing the material below.

    So let’s break it down!

    Lecture on I and O’s

    What is intake? These are fluids taken IN the body. It can be via various routes like the mouth, a tube, or intravenous (IV).

    What do you include for the liquids that are consumed? This includes anything that is liquid at room temperature like:

    • Juice
    • Water
    • Ice chips (NOTE: this melts to half its volume….if you give the patient 8 oz of ice chips RECORD 4 oz)
    • Drinks (coffee, soft drinks, tea etc.)
    • Milk
    • Gelatin (Jell-O ®)
    • Broths
    • Ice cream
    • Frozen treats: popsicles, sorbet
    • Nutrition supplements like Ensure® or Boost ®
      • How about pudding or items similar to it? NO…most NCLEX review guides (example: Kaplan) specify NOT to include pudding etc. in the calculation since it is a semi-liquid (Irwin, Yock & Burckhardt, 2015). However, some sources say to include it (Carter, 2007), but with that being said, ask your professor what they want you to do. However, for this review we will NOT include pudding or products similar to it.

    Many times test questions will give you the amount in ounces (oz), but we record intake and output in milliliters (mL). To convert oz to mL, simply multiply the amount of oz by 30.

    Example: 67 oz = 2010 mL

    Miscellaneous:

    • Tube feedings (include free water)
    • IV and central line fluids (TPN, lipids, blood products, medication infusion)
    • IV and central line flushes
    • Irrigants (example: irrigating a catheter….calculate the amount of irrigate delivered and subtract it from the total urine output…which will equal the urine output)

    Output

    What is output? These are fluids that LEAVE the body. It can be via various routes as well.

    What’s included:

    • Urine output (most of the output calculation)
    • Emesis
    • Liquid stool (ostomy or diarrhea)
    • Wound draining (drains, tubes…example: chest tubes etc.)
    • Suction (gastric, respiratory)

    Not included but needs to be considered is: insensible loss

    This is from the skin and respiratory system. It can’t be measured. According the Mosby’s Medical Dictionary, insensible loss is estimated to be 600 mL/day (“insensible water loss”, 2018).  This varies depending on the patient’s activity level, temperature etc. Therefore, you want to take that in account when assessing if the patient is at risk for fluid volume deficient OR fluid volume overload.

    Interpreting Intake and Output

    • If the intake is less than output or if the output is MORE than the intake….think DEHYRDATION! The patient is losing too much fluids compared to what they are taking in.
    • If the intake is more than output or if the output is LESS than the intake….think that the patient may be retaining fluid and is in FLUID OVERLOAD!

    Example: Intake 4250 mL and Output 1210 mL…..patient is at risk for fluid volume overload.

    Intake and Output Quiz

    References:

    • Carter, P. (2007). Lippincott’s Textbook for Nursing Assistants (2nd ed., p. 403). Lippincott Williams & Wilkins.
    • insensible water loss. (2018) Mosby’s Medical Dictionary, 8th edition. (2009). Retrieved February 8 2018 from https://medical-dictionary.thefreedictionary.com/insensible+water+loss
    • Irwin, B., Yock, P., & Burckhardt, J. (2015). NCLEX-PN 2015-2016 Strategies, Practice, and Review with Practice Test (p. 127). Simon and Schuster.

    When measuring intake and output you may need to convert ounces oz to milliliters mL what does 1 oz equal?

    Basic conversions: = 1 cc. 1 ounce (oz.) = 30 ml.

    Is intake and output in mL?

    Many times test questions will give you the amount in ounces (oz), but we record intake and output in milliliters (mL). To convert oz to mL, simply multiply the amount of oz by 30.

    What unit is intake and output measured in?

    Measuring Intake and Output: The unit used to measure I&O is the milliliter (mL). To measure fluid intake, nurses must convert household measures such as a glass, cup, or soup bowl to metric units. In household measures, 30 mL is equivalent to 1 ounce, 500 mL is about 1 pint, and 1000 mL is about 1 quart.

    How does the nurse properly measure intake and output?

    How does a nurse appropriately measure intake and output? Rationale: All liquids consumed must be counted including liquids with meals, gelatin, custards, ice cream, popsicles, sherbets, and ice chips (recorded as 50% of measured volume [e.g., 100 mL of ice chips equals 50 mL of water]) for the intake record.