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  • Chart Balance Cairan

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    Mira Fitriani Suwarnoo II
    685 views8 pages
    This document contains charts monitoring the fluid intake and output of a patient named Mr. J over 4 days of treatment. It records the amounts of fluids consumed through drinking, eating, and infusion and output through urination, defecation, and vomiting at regular intervals. On the first day, the patient's fluid intake exceeded output by 440ml. On the second day, intake exceeded output by 160ml but on the third day, output exceeded intake by 500ml. On the fourth day, output again exceeded intake, this time by 490ml. The patient's weight decreased from 78kg to 73kg over the 4 days.

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    balance cairan

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    This document contains charts monitoring the fluid intake and output of a patient named Mr. J over 4 days of treatment. It records the amounts of fluids consumed through drinking, eating, and infusion and output through urination, defecation, and vomiting at regular intervals. On the first day, the patient's fluid intake exceeded output by 440ml. On the second day, intake exceeded output by 160ml but on the third day, output exceeded intake by 500ml. On the fourth day, output again exceeded intake, this time by 490ml. The patient's weight decreased from 78kg to 73kg over the 4 days.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    685 views8 pages

    Chart Balance Cairan

    Uploaded by

    Mira Fitriani Suwarnoo II
    This document contains charts monitoring the fluid intake and output of a patient named Mr. J over 4 days of treatment. It records the amounts of fluids consumed through drinking, eating, and infusion and output through urination, defecation, and vomiting at regular intervals. On the first day, the patient's fluid intake exceeded output by 440ml. On the second day, intake exceeded output by 160ml but on the third day, output exceeded intake by 500ml. On the fourth day, output again exceeded intake, this time by 490ml. The patient's weight decreased from 78kg to 73kg over the 4 days.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 8

    Lampiran

    Chart Pemantauan Intake Output Cairan Pasien

    Nama pasien : Tn. J (56 tahun)


    Ruang rawatan : Interne Pria
    Diagnosa Medis : CKD Stage V

    Tanggal : Selasa/ 13 Juni 2017 Berat badan : 78 kg


    Waktu Cairan masuk (ml) Cairan keluar (ml)
    (WIB) Minum Makanan Infus Muntah Urin BAB Keterangan
    01.00 - - - - 300 -
    02.00 - - 500 - - -
    03.00 - - - - - -
    04.00 - - - - - -
    05.00 - - - - 200 200
    06.00 - - - - - -
    07.00 250 40 - - - -
    SUB
    250 40 500 - 500 200
    TOTAL
    08.00 - - 500 - - -
    09.00 - - - - - -
    10.00 250 - - - 200 -
    11.00 - - - - - - IWL = 15/ kg
    12.00 - - - - - - BB/ hari
    13.00 250 40 - - 200 - = 15 x 78
    14.00 - - - - - - = 1.170
    SUB
    500 40 500 - 400 -
    TOTAL
    15.00 - - - - - -
    16.00 - 250 - - -
    17.00 250 - - - - -
    18.00 - - - - 200 -
    19.00 - - - - - -
    20.00 250 30 250 - 200 -
    21.00 - - - - - -
    22.00 250 - - - -
    23.00 - - - - - -
    24.00 - - - - - -
    SUB
    750 30 500 - 400 - 1.170
    TOTAL
    TOTAL/
    1.500 110 1.500 - 1.300 200 1.170
    24 jam
    Balance Cairan = Intake – Output
    = 3.110 ml - 2.670 ml = + 440 ml
    Chart Pemantauan Intake Output Cairan Pasien

    Nama pasien : Tn. J (56 tahun)


    Ruang rawatan : Interne Pria
    Diagnosa Medis : CKD Stage V

    Tanggal : Rabu/ 14 Juni 2017 Berat badan : 78 kg


    Waktu Cairan masuk (ml) Cairan keluar (ml)
    (WIB) Minum Makanan Infus Muntah Urin BAB Keterangan
    01.00 - - - - 300 -
    02.00 - - 500 - 300 -
    03.00 - - - - - -
    04.00 - - - - - -
    05.00 - - - - 200 200
    06.00 300 - - - - -
    07.00 - 30 - - - -
    SUB
    300 30 500 - 800 200
    TOTAL
    08.00 - - 500 - - -
    09.00 200 - - - - -
    10.00 - - - - 200 -
    11.00 100 - - - - - IWL = 15/ kg
    12.00 - - - - - - BB/ hari
    13.00 250 30 - - 200 - = 15 x 78
    14.00 - - - - - - = 1.170
    SUB
    550 30 500 - 400 -
    TOTAL
    15.00 - - - - - -
    16.00 200 - 250 - - -
    17.00 100 - - - - -
    18.00 - - - - 200 -
    19.00 - - - - - -
    20.00 100 20 250 - 200 -
    21.00 - - - - - -
    22.00 100 - - - - -
    23.00 - - - - - -
    24.00 - - - - - -
    SUB
    500 20 500 - 400 - 1.170
    TOTAL
    TOTAL/
    1.350 80 1.500 - 1.400 200 1.170
    24 jam

    Balance Cairan = Intake – Output


    = 2.930 ml - 2.770 ml = + 160 ml
    Chart Pemantauan Intake Output Cairan Pasien

    Nama pasien : Tn. J (56 tahun)


    Ruang rawatan : Interne Pria
    Diagnosa Medis : CKD Stage V

    Tanggal : Kamis/ 15 Juni 2017 Berat badan : 78 kg


    Waktu Cairan masuk (ml) Cairan keluar (ml)
    (WIB) Minum Makanan Infus Muntah Urin BAB Keterangan
    01.00 - - - - 200 -
    02.00 - - 500 - 200 -
    03.00 - - - - - -
    04.00 - - - - 200 -
    05.00 - - - - 150 200
    06.00 200 - - - - -
    07.00 - 30 - - - -
    SUB
    200 30 500 - 750 200
    TOTAL
    08.00 - - 500 - - -
    09.00 200 - - - - -
    10.00 - - - - 200 -
    11.00 200 - - - 200 - IWL = 15/ kg
    12.00 - - - - - - BB/ hari
    13.00 250 20 - - 200 - = 15 x 78
    14.00 - - - - - - = 1.170
    SUB
    650 20 500 - 600 -
    TOTAL
    15.00 - - - - - -
    16.00 200 - 250 - - -
    17.00 100 - - - 200 -
    18.00 - - - - 200 -
    19.00 - - - - - -
    20.00 100 20 250 - 150 -
    21.00 - - - - - -
    22.00 100 - - - -
    23.00 - - - - -
    24.00 - - - - 150 -
    SUB
    500 20 500 - 700 - 1.170
    TOTAL
    TOTAL/
    1.350 70 1.500 - 2.050 200 1.170
    24 jam

    Balance Cairan = Intake – Output


    = 2.920 ml – 3.420 ml = - 500 ml
    Chart Pemantauan Intake Output Cairan Pasien

    Nama pasien : Tn. J (56 tahun)


    Ruang rawatan : Interne Pria
    Diagnosa Medis : CKD Stage V

    Tanggal : Jum’at/ 16 Juni 2017 Berat badan : 78 kg


    Waktu Cairan masuk (ml) Cairan keluar (ml)
    (WIB) Minum Makanan Infus Muntah Urin BAB Keterangan
    01.00 - - - - - -
    02.00 - - 500 - 250 -
    03.00 - - - - - -
    04.00 - - - - 200 -
    05.00 200 - - - 200 200
    06.00 - - - - - -
    07.00 - 100 - - - -
    SUB
    200 100 500 - 650 200
    TOTAL
    08.00 - - 500 - - -
    09.00 100 - - - - -
    10.00 - - - - 200 -
    11.00 200 - - - - - IWL = 15/ kg
    12.00 - - - - 200 - BB/ hari
    13.00 150 100 - - 250 - = 15 x 78
    14.00 - - - - - - = 1.170
    SUB
    450 100 500 - 650 -
    TOTAL
    15.00 - - - - - -
    16.00 150 - 250 - - -
    17.00 100 - - - 250 -
    18.00 - - - - 200 -
    19.00 - - - - - -
    20.00 150 80 250 - 150 -
    21.00 - - - - - -
    22.00 100 - - - - -
    23.00 - - - - -
    24.00 - - - - 150 -
    SUB
    500 80 500 - 750 - 1.170
    TOTAL
    TOTAL/
    1.150 280 1500 - 2.050 200 1.170
    24 jam

    Balance Cairan = Intake – Output


    = 2.930 ml – 3.420 ml = - 490 ml
    Chart Pemantauan Intake Output Cairan Pasien

    Nama pasien : Tn. J (56 tahun)


    Ruang rawatan : Interne Pria
    Diagnosa Medis : CKD Stage V

    Tanggal : Sabtu/ 17 Juni 2017 Berat badan : 73 kg


    Waktu Cairan masuk (ml) Cairan keluar (ml)
    (WIB) Minum Makanan Infus Muntah Urin BAB Keterangan
    01.00 - - - - - -
    02.00 - - 500 - 250 -
    03.00 - - - - - -
    04.00 - - - - 200 -
    05.00 250 - - - 200 200
    06.00 - - - - - -
    07.00 200 100 - - - -
    SUB
    450 100 500 - 650 200
    TOTAL
    08.00 - - 500 - - -
    09.00 200 - - - - -
    10.00 - - - - 200 -
    11.00 200 - - - - - IWL = 15/ kg
    12.00 - - - - 200 200 BB/ hari
    13.00 150 80 - - 250 - = 15 x 73
    14.00 - - - - - - = 1.095
    SUB
    550 80 500 - 650 200
    TOTAL
    15.00 - - - - - -
    16.00 150 - 250 - - -
    17.00 200 - - - 250 -
    18.00 - - - - 200 -
    19.00 - - - - - -
    20.00 150 80 250 - 150 -
    21.00 - - - - - -
    22.00 100 - - - - -
    23.00 - - - - -
    24.00 - - - - 150 -
    SUB
    600 80 500 - 750 - 1.095
    TOTAL
    TOTAL/
    1.600 260 1.500 - 2.050 400 1.095
    24 jam

    Balance Cairan = Intake – Output


    = 3.360 ml – 3.545 ml = - 185 ml
    Chart Pemantauan Intake Output Cairan Pasien

    Nama pasien : Tn. J (56 tahun)


    Ruang rawatan : Interne Pria
    Diagnosa Medis : CKD Stage V

    Tanggal : Minggu/ 18 Juni 2017 Berat badan : 73 kg


    Waktu Cairan masuk (ml) Cairan keluar (ml)
    (WIB) Minum Makanan Infus Muntah Urin BAB Keterangan
    01.00 - - - - - -
    02.00 - - 500 - 250 -
    03.00 - - - - - -
    04.00 - - - - 200 -
    05.00 250 - - - - 200
    06.00 - - - 100 - -
    07.00 100 100 - - 200 -
    SUB
    350 100 500 100 650 200
    TOTAL
    08.00 - - 500 - - -
    09.00 200 - - - - -
    10.00 - - - - 200 -
    11.00 250 - - - 150 - IWL = 15/ kg
    12.00 - - - - 150 - BB/ hari
    13.00 150 100 - - - - = 15 x 73
    14.00 - - - - 200 - = 1.095
    SUB
    600 100 500 - 700 -
    TOTAL
    15.00 - - - - - -
    16.00 150 - 250 - 200 -
    17.00 200 - - - - -
    18.00 - - - - 200 -
    19.00 - - - - - -
    20.00 150 90 250 - 150 -
    21.00 200 - - - - -
    22.00 - - - - 250 -
    23.00 - - - - -
    24.00 - - - - - -
    SUB
    700 90 500 - 800 - 1.095
    TOTAL
    TOTAL/
    1.650 290 1.500 100 2.150 200 1.095
    24 jam

    Balance Cairan = Intake – Output


    = 3.440 ml – 3.545 ml = - 105 ml
    Chart Pemantauan Intake Output Cairan Pasien

    Nama pasien : Tn. J (56 tahun)


    Ruang rawatan : Interne Pria
    Diagnosa Medis : CKD Stage V

    Tanggal : Senin/ 19 Juni 2017 Berat badan : 73 kg


    Waktu Cairan masuk (ml) Cairan keluar (ml)
    (WIB) Minum Makanan Infus Muntah Urin BAB Keterangan
    01.00 - - - - 250 -
    02.00 - - 500 - - -
    03.00 - - - - - -
    04.00 - - - - 200 -
    05.00 250 - - - - 200
    06.00 150 - - - - -
    07.00 - 150 - - 250 -
    SUB
    400 150 500 - 700 200
    TOTAL
    08.00 - - 500 - - -
    09.00 200 - - - - -
    10.00 - - - - 200 -
    11.00 250 - - - 150 - IWL = 15/ kg
    12.00 150 - - - - - BB/ hari
    13.00 - 100 - - 200 - = 15 x 73
    14.00 - - - - 200 - = 1.095
    SUB
    600 100 500 - 750 -
    TOTAL
    15.00 - - - - - -
    16.00 150 - 250 - 200 -
    17.00 250 - - - - -
    18.00 - - - - 200 -
    19.00 - - - - - -
    20.00 150 150 250 - 150 -
    21.00 200 - - - - -
    22.00 - - - - 250 -
    23.00 - - - - -
    24.00 - - - - - -
    SUB
    750 150 500 - 800 - 1.095
    TOTAL
    TOTAL/
    1.650 400 1.500 - 2.250 200 1.095
    24 jam

    Balance Cairan = Intake – Output


    = 3.550 ml – 3.545 ml = + 5 ml
    Chart Pemantauan Intake Output Cairan Pasien

    Nama pasien : Tn. J (56 tahun)


    Ruang rawatan : Interne Pria
    Diagnosa Medis : CKD Stage V

    Tanggal : Selasa/ 20 Juni 2017 Berat badan : 73 kg


    Waktu Cairan masuk (ml) Cairan keluar (ml)
    (WIB) Minum Makanan Infus Muntah Urin BAB Keterangan
    01.00 - - - - 250 -
    02.00 - - 500 - - -
    03.00 - - - - - -
    04.00 - - - - 200 -
    05.00 250 - - - - 200
    06.00 150 - - - - -
    07.00 - 150 - - 250 -
    SUB
    400 150 500 - 700 200
    TOTAL
    08.00 - - 500 - - -
    09.00 200 - - - - -
    10.00 - - - - 200 -
    11.00 250 - - - 200 - IWL = 15/ kg
    12.00 150 - - - - - BB/ hari
    13.00 - 100 - - 200 - = 15 x 73
    14.00 - - - - 200 - = 1.095
    SUB
    600 100 500 - 800 -
    TOTAL
    15.00 - - - - - -
    16.00 - - 250 - 200 -
    17.00 250 - - - - -
    18.00 100 - - - 200 -
    19.00 - - - - - -
    20.00 150 150 250 - 200 -
    21.00 200 - - - - -
    22.00 - - - - 200 -
    23.00 - - - - -
    24.00 - - - - - -
    SUB
    700 150 500 - 800 - 1.095
    TOTAL
    TOTAL/
    1.700 400 1.500 - 2.300 200 1.095
    24 jam

    Balance Cairan = Intake – Output


    = 3.600 ml – 3.595 ml = + 5 ml

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