Fluid Balance

It is essential to promote and support good hydration in patients. Read the illustrated guide to Fluid Balance and Promoting Good Hydration on ClinicalSkills.net below. The guide focuses on a care home setting, however many of the principles are applicable in any care settings, and promoting and supporting good hydration is the responsibility of the whole multidisciplinary care team in any setting. The guide outlines reasons why it is important for patients to be well hydrated and some of the problems which can result from poor hydration or dehydration.  It also offers some useful points around promoting good hydration, which you might see or use in practice. The guide begins to outline what is meant by the term 'fluid balance' - but you can read more detail about this, including how to fill in a fluid balance chart in the additional resources and guides listed further down this page. 

Fluid Balance and Promoting Good Hydration

Now move on to the next guide which goes into more detail around methods to assess a patient's hydration status, including ways to spot a dehydrated patient. There are both adult and paediatric focused versions of this available below. The guides also look at detecting dehydration and acute kidney injury (AKI) and consider useful indicators in blood tests. Finally, the guides outline how to accurately measure fluid output from various sources and how to record this on an example of a fluid balance chart. In the adult focused guide, there are also two useful case studies to read which focus on hypo- and hypervolaemia. Click below to read these:

Assessing and Measuring Fluid Balance (Adult) 

Assessing and Measuring Fluid Balance (Child) 

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If you'd like to read more detail about fluid balance, including related anatomy and physiology, professional issues and assessing fluid status, click on the link here to access an interesting article from the British Journal of Nursing: 

Measuring and Monitoring Fluid Balance 

The video below from East Lancashire Hospitals NHS Trust outlines why good hydration is important, as well as why we need to monitor fluid balance in our patients. It also provides tips for gaining information about a patient's hydration status and begins to look at recording the information you gather around inputs and outputs.

Click below to watch...

The second video here is a really useful resource from The Rotherham NHS Foundation Trust, outlining how fluid balance monitoring is undertaken. The video also goes into more detail about how a fluid balance chart should be completed accurately and how to avoid mistakes. Although some of the documentation and points in the video covered refer specifically to this Trust,  lots of the information is very relevant to any area or Trust you might work in. 

Click below to watch...

Click on the button below to navigate to the 'Take a Test' area of ClinicalSkills.net. Please make sure you're logged into ClinicalSkills.net already, otherwise you may not be able to open and take the test. Once you have reached the 'Take a Test' area, select 'Standard Tests' and then click on the test called 'Assessing and measuring fluid balance (adults)' to begin. You will need to score 80% or more to pass. Make sure you've read the ClinicalSkills.net procedure thoroughly before taking the test as many of the answers will be found within there!

Royal Marsden Manual of Clinical Nursing Procedures (9th Edition): Fluid Balance- Page 122 - 134

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