Fluid Balance
Observation time (h):
Current weight (g):
Previous weight (g):
Birth weight (g) — optional:
Total daily urine (ml):
Daytime urine — total (ml):
1st daytime urine (ml):
2nd daytime urine (ml):
3rd daytime urine (ml):
4th daytime urine (ml):
5th daytime urine (ml):
Nighttime urine — total (ml):
1st nighttime urine (ml):
2nd nighttime urine (ml):
3rd nighttime urine (ml):
4th nighttime urine (ml):
5th nighttime urine (ml):
Daytime fluids (ml):
Nighttime fluids (ml):
Yes
No, use current
Gastric residuals
▼
gastric residuals (day):
ml
food
mucoid
bilious
bloody
gastric residuals (night):
ml
food
mucoid
bilious
bloody
Stoma losses
▼
How many portions per day:
8x
10x
ml per portion:
ml
1
2
3
4
Day sum
Total
0 ml
5
6
7
8
Night sum
0 ml
0 ml
1
2
3
4
5
Day sum
Total
0 ml
6
7
8
9
10
Night sum
0 ml
0 ml
stoma losses (day):
ml
stoma losses (night):
ml
Drains
▼
Abdominal cavity drain
Yes
No
during day (ml):
ml
serous
serosanguineous
bloody
during night (ml):
ml
serous
serosanguineous
bloody
Redon drain
Yes
No
during day (ml):
ml
serous
serosanguineous
bloody
during night (ml):
ml
serous
serosanguineous
bloody
Right pleural cavity drain
Yes
No
during day (ml):
ml
serous
serosanguineous
bloody
during night (ml):
ml
serous
serosanguineous
bloody
Left pleural cavity drain
Yes
No
during day (ml):
ml
serous
serosanguineous
bloody
during night (ml):
ml
serous
serosanguineous
bloody
Calculate Balance
Clear
