The nurse is reviewing a client's fluid intake and output record. Fluid intake and urine output should relate in which way?

• A. Fluid intake should be approximately equal to the urine output.
• B. Urine output should be greater than fluid intake by 50%.
• C. Fluid intake should be twice urine output.
• D. Urine output should be less than fluid intake.

Answer: (A)

Fluid balance is a balance between what you take in and what you lose. In a stable person, the amount of fluid consumed through mouth, food, and IVs should roughly equal what is excreted, mainly as urine, with additional losses through skin, respiration, and stool. Those insensible losses aren’t measured, so the best expectation is that intake and urine output are approximately the same over a 24-hour period. If urine output were much greater than intake, you’d see a negative fluid balance and potential dehydration; if intake were much greater than urine output, a positive balance could lead to edema or overload. The other ratios don’t reflect the reality of variable, often unmeasured, fluid losses, so approximate equality is the most accurate guide for normal fluid status.