Measuring Intake and Output for Inpatients

Why measure intake and output?

Your child might receive medicines that affect how well their bladder or kidneys work. Your health care provider may ask you to keep track of your child’s intake and output (I and O). This important information helps your child’s team quickly spot any imbalances in fluids, electrolytes, or calories (energy from food).

You must record all intake – everything your child eats and drinks. You should also record all output – all urine, stool, and vomit. A staff member will subtract the output from the intake to find your child’s fluid balance.

How to measure and record intake

Write anything your child takes in on the Intake and Output (I and O) card. This card is kept in a box on the wall by the patient room door. As shown below, the card title says “24-Hour Intake.” The card has 3 sections: 

• 7 a.m.–3 p.m.

• 3–11 p.m.

• 11 p.m.–7 a.m.  

Write all solid food eaten by your child on the left side of the card. Use the right side of the card to write all liquid taken by your child. 

You must write down everything your child eats or drinks. Be sure to include:

• The time

• The type of liquid your child drank

• Any solid food they ate 

• The amount offered

• The amount your child drank or ate

For liquids, write the number of ounces (you can also find this on the drink container, or measurement on a baby bottle). Also write the amount of solid food, such as cereal, chicken, and bread.

Here is an example of how to record food and liquids:

The clear cups in the Nutrition Center include measurements. You can also pour drinks into them to measure the amount of liquids. 

The right side of the I and O card also lists measurements for such items as popsicles, ice cream, and Jell-O®. 

Your child’s health care provider will record fluids your child receives through a central venous line, peripheral venous catheter, nasogastric, or gastronomy feeding tube (if needed). 

How to measure and record output

You must measure all urine, stool (bowel movements), and vomit.

Write this output on the I and O card. The title on one side of the card reads 24-Hour Output.” The card has 3 sections: 

• 7 a.m.–3 p.m.

• 3–11 p.m.

• 11 p.m.–7 a.m. 

This side of the card has columns for recording urine, vomit, stool, and mixed stool and urine.

Every time your child urinates or vomits, you must record the time and amount. The nurse will give you an open container (known as a “hat”) to measure urine and vomit. The hat fits on the rim of the toilet to collect urine. You must record urine and vomit as ml (example: 500ml).

You can also collect and measure vomit in a smaller container known as an emesis basin or bag. Your child’s health care providers will give you this container.

You need to record the number of bowel movements, but not the amount. If your child has 1 bowel movement, write X 1 on the card along with the time of the bowel movement.

Infants need to have their diaper checked or changed every 2 hours. If your child is older, take them to the bathroom every 2 hours, even at night. 

If your child wears diapers, weigh used diapers on the scale that is in your room. Your child’s health care provider will show you how to use the scale.

Your child’s health care provider will record fluids that come out of your child’s nasogastric tube, chest tubes, and foley catheter. Your child’s team will watch the I and O cards during the day and night. A staff member may wake up your child and ask them to urinate in the bathroom if no output is recorded for 2 hours.