Long-Term Care

Trainer’s tip: Residents who may require I&O monitoring

LTC Nursing Assistant Trainer, February 11, 2010

Intake and output (I&O) monitoring is a simple procedure that does not require a physician’s order. Sadly, nurses sometimes do not take this important intervention seriously. Write the need for I&O monitoring, as well as any special approaches or resident preferences, on the care plan. If the resident is known to be at high risk of dehydration upon admission, begin a temporary care plan to address this risk.

Facility personnel should routinely monitor fluid balance (I&O) for the following:

  • All residents receiving tube feedings
  • Residents with catheters
  • Residents with urinary tract infections
  • Residents with physician orders for fluid restrictions or orders to force (encourage) fluids
  • Residents with specific physician orders for additional liquid (fluid)
  • Residents who are known to be dehydrated or who are at risk for dehydration
  • Residents with certain heart and kidney conditions that are at high risk for fluid imbalance
  • Residents receiving intravenous fluids or parenteral nutrition therapy
  • Any resident who develops a fever, vomiting, diarrhea or a nonfebrile infection, unexplained weight loss or gain, pedal edema, neck vein distension, or shortness of breath

This is an excerpt from HCPro’s book, The Long-Term Care Nursing Desk Reference, Second Edition, by Barbara Acello, MS, RN.

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