Fluid Balance Chart

Assessment of fluid balance requires close observation and monitoring of the

patient, recognizing that certain groups of patients such as the elderly and
children are at particular risk. The fluid balance chart is used as a noninvasive tool to assess the patient's hydration status.
The purpose of the procedure is that the accurate measurement in the
recording of patients intake and output is crucial to the patients overall
wellbeing. Also, close monitoring and observation of the patient will provide
early detection of fluid imbalance, especially essential to patients who are
administered diuretics.
Before the procedure the nurse must perform handwashing, the universal
precaution, and proper PPE gloves.
Equipment used in the recording are blood pressure apparatus to measure
blood pressure and central venous pressure; Weighing scale to measure
weight; and Thermometer to measure temperature. Nurses convert glass,
cup, or soup bowl to metric units (mL) to accurately measure intake and
output.
The nursing assessment of fluid balance should include: the patients history,
physical examination, clinical observation and interpretation of laboratory
results. A detailed account of the patients history should be taken especially
the fluid intake and output. The nurse may have to rely on relatives and care
givers to give this information if the patient is unable to. A clinical
assessment of the patient should be carried out including vital observations
such as measuring the blood pressure, pulse, respiration and temperature.
The patients physical appearance should also be noted: attention should be
paid to the skin, tongue, and face. The general well-being of the patient is
also a good indication of fluid loss or gain. Central venous pressure (CVP) is a
measurement of pressure in the right atrium of the heart. The CVP recording
is a good indication to determine the amount of fluid contained within the
body.
After the procedure, handwashing must be done. After is the accurate and
proper documentation. All fluid balance charts should be completed with the
patients name, date, ward and hospital number. The nurse should record the
type and amount of all fluids the patient has taken and lost and the route.