Nursing Fluid Balance Monitoring Chart
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Create a fluid balance monitoring documentation for patient on [fluid restriction/fluid resuscitation].

Patient details:
- Indication: [fluid overload/dehydration/post-op/other]
- Fluid restriction if applicable: [mL per 24 hours]
- Fluid resuscitation goal if applicable: [mL per hour]
- Foley catheter: [yes/no]

FLUID BALANCE DOCUMENTATION

INTAKE (mL)

ORAL INTAKE
- Breakfast: [mL]
- Lunch: [mL]
- Dinner: [mL]
- Snacks and beverages: [mL]
- Ice chips: [mL — count as half]
- Total oral: [mL]

IV INTAKE
- Primary fluid: [type and rate — mL]
- Secondary infusions: [list with mL]
- IV medications: [total mL]
- Blood products: [if applicable — mL]
- Total IV: [mL]

TUBE FEEDINGS (if applicable)
- Formula: [type]
- Rate: [mL/hour]
- Total: [mL]

TOTAL INTAKE: [mL]

OUTPUT (mL)

- Urine: [mL — per void or catheter]
- Emesis: [mL — if present]
- Wound drainage: [mL — if applicable]
- Chest tube: [mL — if applicable]
- Nasogastric: [mL — if applicable]
- Stool: [estimated if applicable]

TOTAL OUTPUT: [mL]

FLUID BALANCE: [+ or - mL]
Cumulative balance: [24-hour total]

CLINICAL ASSESSMENT
- Edema: [present/absent — location]
- Skin turgor: [adequate/tenting]
- Mucous membranes: [moist/dry]
- Lung sounds: [clear/crackles]
- Daily weight: [kg — change from yesterday]

Note: Placeholder information only

Source: https://promptzyo.com/prompt/nursing-fluid-balance-monitoring-chart