What is the difference between strict I&O and fluid restrict?

erosanguenous fluid

Paper instructions:
Intake & Output Activity

Review each scenario. Answer the I&O related questions. There are 20 questions, each is worth 5 points.

Scenario 1:

Mr. Juan Garcia is a 60-year-old male presents to the clinic with a diagnosis of congestive heart failure. He has experienced increased fatigue and shortness of breath on exertion over the last

week. He has peripheral swelling of 4+ edema to the lower extremities. He has had a decreased appetite with a weight gain of 10 lbs over the last 2 months.
The health care provider has admitted the patient to the telemetry floor with the following orders:

Medical Orders
Today Admit to telemetry: DX: Congestive Heart Failure
0945 Tele monitoring
VS q 4 hr
O2 2LNC titrate to keep O2 sats > 92%
Diet: Oral Fluid Restrict 17oomL /24 hours; low sodium diet
Saline lock IV
Place foley to gravity
Strict I & O
Daily Weight
Labs:
BNP,CMP, BMP, PT, PTT, INR in am tomorrow
Cxr in am tomorrow
ECG Now (done in ER)
2 D Echocardiogram (done in ER)
Medications:
Lasix 40mg IV BID
Altace 5 mg PO daily
Coreg 3.125mg PO BID (hold for SBP < 90)
Coumadin 2.5 mg PO daily
Tylenol 625 mg PO prn temp >100 degrees F
John Marshall, MD Today @ 0730
Garcia, Juan
MR # 06992
DOB: 8/23/1949 Physician: Dr. Marshal
Admit date: Yesterday

1. What is the difference between strict I&O and fluid restrict?

2. How will the 1700mL fluid restrict be divided over the 24 hour period in three 8 hour shifts?

Scenario 1 Continued:

In the last 8 hour shift (7a-3p), for breakfast Mr. Garcia had toast with 1 packet of jam and 4oz of orange juice. At 0900 the nurse administered 40mg of Lasix that came in a 40mg/4mL vial (4mL

total) with a 10mL saline flush. He consumed his am medications with 45mL of water. At 1100 the CNA recorded 1500mL from the Foley catheter. For lunch Mr. Garcia had a 50mL of water and ½

cup of sugar-free jello with his meal. At 1230, Mr Garcia had a solid well-formed bowel movement. At 1300, the nurse administered Tylenol as ordered for a temp of 100.2 degrees F with 40mL of

water. At 1500 the CNA recorded 475 mL from the Foley catheter.

3. What is the intake for the 8 hour shift?

4. What is the output for the 8 hour shift?

5. Is the intake within the 1700mL fluid restrict for the first 8 hour shift?

6. What is the fluid balance for the 8 hour shift? (Is it positive or negative? And by how much?)

7. What is the cause of the imbalance and in your nursing judgment is it an expected outcome, why?