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Asked by AmbassadorPower4026

Using the information below, record the details using the fluid balance chart attached at end of assessment.

Note include all fluids the only dietary oral is soup.

Fluid measures

1 cupÂ Â Â Â Â Â =Â 150 ml

1 glassÂ Â Â Â =Â 150 ml

1 bowlÂ Â Â Â =Â 100 ml

Small milk jugÂ =Â 100Â ml

Bowel actions

8.00amÂ Â Â Â Â Â Bowels opened, well formed

Urine voided

4.00amÂ Â Â Â Â Â Â Â Â Â Â Â 300ml

8.00amÂ Â Â Â Â Â Â Â Â Â Â Â 200ml

11.00amÂ Â Â Â Â Â Â Â Â Â 100ml

1.00pmÂ Â Â Â Â Â Â Â Â Â Â Â 150ml

4.00pmÂ Â Â Â Â Â Â Â Â Â Â Â 150ml

7.00pmÂ Â Â Â Â Â Â Â Â Â Â Â 100ml

9.00pmÂ Â Â Â Â Â Â Â Â Â Â Â 100ml

Â Â Â Â Â Â Â Â Â 11.00pmÂ Â Â Â Â 100ml

Fluid Intake

Early morning cup of tea.

Milk on porridge and a cup of tea for breakfast.

Glass of orange juice at morning tea.

Glass of water during the morning.

Bowl of soup and glass of orange juice for lunch.

Cup of tea at afternoon tea time.

Glass of water during the afternoon.

Bowl of soup and a cup of tea at tea time.

Glass of Milo for supper.

Glass of water at bedtime

Last name

MRN Â

Given name

DOB Â
Doctor: Â
Gender: Â
Ward: Â
Date

Weight

INPUT

OUTPUT Â
TIME ORAL FLUID ORAL DIETARY Vomitus Urine Bowels Comments Â
0100 Â Â Â Â Â Â Â
0200 Â Â Â Â Â Â Â
0300 Â Â Â Â Â Â Â
0400 Â Â Â Â Â Â Â
0500 Â Â Â Â Â Â Â
0600 Â Â Â Â Â Â Â
0700 Â Â Â Â Â Â Â

Sub total

Â Â Â Â Â Â Â
08000 Â Â Â Â Â Â Â
0900 Â Â Â Â Â Â Â
1000 Â Â Â Â Â Â Â
1100 Â Â Â Â Â Â Â
1200 Â Â Â Â Â Â Â
1300 Â Â Â Â Â Â Â
1400 Â Â Â Â Â Â Â

Sub total

Â Â Â Â Â Â Â
1500 Â Â Â Â Â Â Â
1600 Â Â Â Â Â Â Â
1700 Â Â Â Â Â Â Â
1800 Â Â Â Â Â Â Â
1900 Â Â Â Â Â Â Â
2000 Â Â Â Â Â Â Â
2100 Â Â Â Â Â Â Â
2200 Â Â Â Â Â Â Â
2300 Â Â Â Â Â Â Â
2400 Â Â Â Â Â Â Â

Sub total

Â Â Sub total Â Â Â Â

24hr total

Â Â 24hr total Â Â Â Â

Total INPUT

Total OUTPUT Â

BALANCE

Â Â
Â

SCIENCE
HEALTH SCIENCE
NURSING
HLT 54421

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