The nurse is caring for a client with fluid overload who is on strict I’s and O’s. The nurse understands that which is the best way to ensure accurate I’s and O’s?
clear any IV pumps and reset to zero for accurate IV fluid intake
ask the client to keep up with how many cups of fluid he drinks at meals
ask the client to report how much urine is in the urinal each time he uses it
tell the client not to ask for any extra water or drinks that are not on the meal tray
Number 1 is correct.
Rationale: Clearing the pump ensures that IV fluid intake will be accurate. A client on strict I’s and O’s is not necessarily on fluid restriction, and may receive IV fluids, blood, or antibiotics and other medications. Options 2 and 3 shift responsibility from the nurse to the client, which is not acceptable. The nurse monitors all intake and output. Option 4 is rude and not appropriate; the client may ask for other fluids in between meals.
