Question

# Mr. Biller was admitted to your medical-surgical unit at 0300 this morning. He received 2.5 mg...

Mr. Biller was admitted to your medical-surgical unit at 0300 this morning. He received 2.5 mg morphine IV in the emergency department and has been resting comfortably since admission. You assume care for Mr. Biller at 0600.

The patient had an IV his in left forearm (median vein) started in the emergency department. The IV is patent with no redness or swelling visible, and the dressing is intact. The emergency department nurse has already calculated the intake and output from her care.

An IV was started at 0300 and is infusing Lactated Ringers at 120 mL/hour. The patient voided 150 mL dark amber urine per urinal at 0500. The unit admission nurse gave the patient 50 mL of ice chips at 0400 because he was complaining of thirst.

What is the patient intake and output totals in the HER?

What is Mr. Biller's intake and output balance? What does this mean for your patient?]

The intake is :-

• 120 ml / hr IV fliuds x 3 (from 03.00 to 06.00) = 360 ml
• Ice chips = 50 ml

So, Total intake = 410 ml

Urine volume = 150 ml

So, Total output = 150 ml

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Intake output balance = Total intake - Total output = 410 - 150 = 260 ml

Here, the  fluid gain is greater than fluid loss i.e, positive fliud balance. A positive fliud balance indicates that the fliud is retained within the body which suggests a problem with the kidney or the cardiovascular system.