Fluid balance charts

Each hospital or care facility will have its own form of fluid balance chart but they will all follow a similar format, requiring the nurse to record all types of fluid input and output, including:

• oral fluids
• enteral feed
• intravenous fluids
• blood and plasma
• urine
• vomit
• wound drainage
• nasogastric aspirate
• diarrhoea.

Figure 5.5 Fluid balance chart

You should always explain to the client why the recording is necessary and what the client is required to do (for example collecting and measuring urine) when you need to observe and record the nature and quantity of both input and output. The fluid balance chart should be assessed at regular intervals so that the input can be adjusted as required or abnormalities detected and reported promptly. Accurate recording of both intake and output is essential to be able to calculate the fluid balance correctly. The fluid balance should be totalled at the end of each 24-hour period and care needs reassessed.