Nurse Pippy is reviewing a client’s fluid intake and output record. Fluid intake and urine output should relate in which way?
A. Fluid intake should double the urine output.
B. Fluid intake should be approximately equal to the urine output.
C. Fluid intake should be half the urine output.
D. Fluid intake should be inversely proportional to the urine output.
Correct Answer: B. Fluid intake should be approximately equal to the urine output.
Normally, fluid intake is approximately equal to the urine output. Any other relationship signals an abnormality. The core principle of fluid balance is that the amount of water lost from the body must equal the amount of water taken in; for example, in humans, the output (via respiration, perspiration, urination, defecation, and expectoration) must equal the input (via eating and drinking, or by parenteral intake).
Option A: Fluid intake that is double the urine output indicates fluid retention. Fluid retention (edema) occurs when the fluid isn’t removed from the tissues. The two broad categories of fluid retention include generalized edema, when swelling occurs throughout the body, and localized edema when particular parts of the body are affected.
Option C: Fluid intake that is half the urine output indicates dehydration. Body water is lost through the skin, lungs, kidneys, and GI tract. The loss of body water without sodium causes dehydration. Water is lost from the skin, lungs, gastrointestinal tract, and kidneys. Dehydration results when water losses from the body exceed water replacement. It may be caused by failure to replace obligate water losses.
Option D: Normally, fluid intake isn’t inversely proportional to the urine output. One general principle for all patient scenarios is to replace whatever fluid is being lost as accurately as possible. These fluid losses can differ depending on patients’ medical conditions and differ by both volume and composition.
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