Factors which influence the accuracy of fluid intake and output

Fluid and electrolyte balance is one of the most important processes in the body upon which life itself depends. Nearly every medical and surgical condition threatens to upset this balance. It is the responsibility of the physician to supply fluids when the mechanisms which normally regulate homeostasis are not functioning properly. The professional nurse is expected to give better, more intelligent nursing care through knowledge and application of scientific principles which underlie fluid and electrolyte metabolism. Only by knowing these principles about the water balance, the portals by which fluids leave the body, and the mechanisms that control the volume and distribution of fluid in the body can she realize and appreciate how important it is to supply the physician with accurate and comprehensive records of all fluids that are taken in or lost from the body. Nursing has not kept pace with the advances medical science has mad recently relative to the body ills due to imbalances of body fluids. Nurses need to become more aware of the principles basic to an understanding of fluid and electrolyte balance and to apply these principles as they give nursing to patients. From the review of literature and according to the physician with whom the writer has discussed the problem, it was concluded that it is difficult to obtain an accurate fluid intake and output record. In discussing the problem with nurses, however, the majority of nurses were of the opinion that intake and output measurement and records were done as well as possible. This study was an attempt to determine whether nurses did possess the knowledge necessary to obtain an accurate intake and output record. A questionnaire was devised composed of questions that a committee made up of physicians and nursing educators thought were necessary for the nurse to know if she were to be able to give intelligent nursing care as related to fluid balance. This questionnaire was completed by fifty nurses who care for medical-surgical patients. The findings from this questionnaire showed the 34 per cent of the respondents did possess the knowledge necessary to give good nursing care relative to fluid balance; that 42 percent might give adequate nursing care, and the 24 per cent did not posses the knowledge necessary to enable them to measure and record intake and output accurately. Statistically there appeared to be no significant relationship between the type of basic nursing education program from which the participants graduated and the average score they made. Those nurses who received baccalaureate degree from a four-year school of nursing did better that those who graduated from a two or three-year program. The highest average score was achieved by the 21 to 30 age group who had four years of nursing education. There was not an adequate representation of all types of nursing education in all age group, thus the researcher was unable to draw any definite conclusions. A larger sampling with the use of an improved tool may substantiate the conclusion of this writer that more information about fluid balance must be included in the curriculum of school of nursing and that those nurse who have already graduate must be informed of these new advances in nursing through continued education and inservice programs.