| Course | NSG 122 Nursing Fundamental Concepts |
|---|---|
| Unit | Unit 4 |
| Paper type | Skill rationale write-up |
| Length | About 320 words, 4 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 122 Unit 4
Measuring Intake and Output, Line by Line: The Steps in the Order the Skills Text Gives Them, and What Each One Protects
Student Name
Department of Nursing, Herzing University
NSG 122: Nursing Fundamental Concepts
Instructor Name
February 4, 2026
Measuring Intake and Output, Line by Line: The Steps in the Order the Skills Text Gives Them, and What Each One Protects
The Skill and Why It Was Chosen
The skill is measuring and recording intake and output for an adult on strict monitoring, as used for the composite 84-year-old man with fluid loss followed in Units 1 to 3. His first goal depends on output of at least 30 mL an hour, so the accuracy of every entry decides whether that goal is judged correctly. Steps follow the order in the course skills text (Potter et al., 2023). Steps marked [ID] exist for identification, [PRIV] for privacy, and [IC] for infection control; these recur in almost every skill.
The Steps and Their Reasons
Left column: the step. Right column: what it protects, prevents, or makes possible.
| Step | Reason |
|---|---|
| 1. Check the order and the facility's intake and output policy, including which items count as intake. | Units differ on what is counted, such as ice chips at half their volume or gelatin as fluid. Knowing the rule before measuring prevents entries that cannot be compared between shifts. |
| 2. Explain to the patient and family why every drink and every void is being measured, and ask them to save urine and tell staff about drinks. [PRIV] | The patient and visitors are the main source of missed intake. A man who "doesn't want to be a bother" will not report drinks unless he knows why it matters. |
| 3. Place a sign at the bedside and a measuring container (a urine hat or urinal) in the bathroom. | Makes the measurement visible to every staff member and every visitor, so nothing is poured away unmeasured. |
| 4. Perform hand hygiene and put on gloves before handling urine or stool. [IC] | Protects the nurse and the next patient from organisms in body fluids; this patient has an infectious diarrhea. |
| 5. Confirm the patient's identity with two identifiers before recording on his chart. [ID] | Output recorded on the wrong chart gives two patients false totals, and for this patient a false total could hide a missed goal. |
| 6. Measure intake from drinks by the marked volume of the cup, and record intravenous fluids from the pump's volume infused. | Estimates by eye are commonly off; marked cups and pump totals give a figure another nurse can check. |
| 7. Pour urine from the hat or urinal into a graduated cylinder and read at eye level on a flat surface. | Container markings are approximate; reading a graduated cylinder at eye level avoids errors from the angle of view. |
| 8. Record loose stools by count and estimated volume, and vomitus by measured or estimated volume, noting which is an estimate. | Diarrhea is a real fluid loss for this patient. Marking estimates as estimates tells the next reader how much to trust the number. |
| 9. Discard the fluid, clean the container, remove gloves, and perform hand hygiene. [IC] | Prevents contamination of the bathroom and the next measurement. |
| 10. Record each entry immediately with the time, and total at the end of the shift. | Entries made from memory at the end of a shift are where most errors enter. Timed entries also show whether output is steady or falling. |
| 11. Compare the shift total with the goal and with the previous shift, and report two consecutive hours under 30 mL. | The measurement only protects the patient if someone acts on it; this step links the skill back to his goal. |
Why Accuracy Needs a Cross-Check
Intake and output totals can be wrong even when every step is followed, because some losses are never measured, such as sweat and breath, and some entries are missed. A study of intensive care patients found that cumulative fluid balance charts were inaccurate in about a third of cases when compared with measured body weight (Perren et al., 2011). For this reason the plan pairs intake and output with a daily weight on the same scale. If the chart says he is gaining fluid but his weight is falling, the chart is checked for missed entries before either number is trusted. Bedside signs are no substitute for either measure, since single signs perform poorly at detecting dehydration in older adults (Hooper et al., 2015).
Note on Standards
Technique standards differ between texts and facilities: some count ice chips at half their volume and some at the full volume, and some require output to be measured every hour and others every shift. The steps above follow the course skills text; the facility's policy governs in practice. The patient is a composite.
References
Hooper, L., Abdelhamid, A., Attreed, N. J., Campbell, W. W., Channell, A. M., Chassagne, P., Culp, K. R., Fletcher, S. J., Fortes, M. B., Fuller, N., Gaspar, P. M., Gilbert, D. J., Heathcote, A. C., Kafri, M. W., Kajii, F., Lindner, G., Mack, G. W., Mentes, J. C., Merlani, P., ... Hunter, P. (2015). Clinical symptoms, signs and tests for identification of impending and current water-loss dehydration in older people. Cochrane Database of Systematic Reviews, Article CD009647. https://doi.org/10.1002/14651858.CD009647.pub2
Perren, A., Markmann, M., Merlani, G., Marone, C., & Merlani, P. (2011). Fluid balance in critically ill patients: Should we really rely on it? Minerva Anestesiologica, 77(8), 802-811.
Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2023). Fundamentals of nursing (11th ed.). Elsevier.
What the NSG 122 Unit 4 instructions ask for
Unit 4 asks you to explain the rationale for each step of a nursing skill. Expect to state the skill and why you chose it, list steps in order with a rationale for each, explain how accuracy is checked and note where standards differ. Many versions ask how detailed rationales should be and which text to follow. Check whether your section names the skill. Each rationale should say what the step protects, prevents or makes possible, not just restate it. Cross-checks show the skill's limits. Facility policies sometimes differ from textbooks; note that and follow the facility. Keep the format clear, often a two-column table, so each step and reason sit side by side.
Inside the NSG 122 Unit 4 example
The write-up opens with the skill and the patient context that makes it important. The table lists steps on the left and reasons on the right, in the text's order. Reasons are specific, such as wearing gloves to protect against body fluid exposure or using graduated containers for accuracy. The cross-check section explains how daily weights and patterns help catch errors in totals. The standards section notes differences between texts and facilities and advises following local policy. The write-up is short and practical. Every reason points to a concrete outcome, which is what separates a rationale from a restatement of the step.
NSG 122 Unit 4 rubric: what full points look like
Herzing's rubric for a skill rationale typically covers completeness of steps, accuracy of sequence, quality of rationales, attention to accuracy checks and awareness of differing standards. Rationales are judged on whether each one names what the step protects or prevents, not on length. Completeness points reward every step the text lists, including explaining the purpose to the patient. Sequence criteria look for the text's order or a stated reason for departing from it. Accuracy check points go to independent measures such as daily weight. Standards awareness earns credit when differences between texts and facilities are noted. A two-column table helps. Correct units for every measure are expected. The rationale draws on the Potter text's intake and output procedure.
Common NSG 122 Unit 4 mistakes, and how to avoid them
Skill rationales in Unit 4 commonly lose points by restating the step as the reason, such as measure output to know the output. Another frequent problem is skipping steps such as explaining the purpose to the patient and family, who often record intake themselves. Students often miss cross-checks such as weight. Rationales are generic, such as for safety, without saying how. The order differs from the text without explanation. Facility differences are ignored. Units are not specified. Ice chips, tube feedings and irrigation fluid are forgotten in the intake column. Finally, say what each step prevents, because graders reward rationales that would help a new nurse understand why skipping a step causes errors in the totals.
Get a NSG 122 Unit 4 example written to your instructions
Send the Unit 4 instructions and the rubric from your NSG 122 classroom, and name the skill the write-up covers. We write a custom example that runs the sequence and its reasons in parallel, cites each reason to the material you send, and marks the elements that recur in every skill. First custom sample free, back in 24 to 48 hours.
More NSG 122 papers and BSN samples
- NSG 122 Unit 1: Nursing process walkthrough
- NSG 122 Unit 2: Patient problem statement set
- NSG 122 Unit 3: Measurable goal and outcome sheet
- NSG 122 Unit 5: Patient needs ordering brief
- NSG 122 Unit 6: Safety and mobility plan
- NSG 122 Unit 7: Basic care procedure record
- NSG 122 Unit 8: Fundamentals skills file
- NSG 222 Unit 4: Newborn transition record
- NSG 223 Unit 4: Complex adult case file
- NSG 233 Unit 4: Escalation decision record
- NSG 298 Unit 4: Concept linking exercise
NSG 122 Unit 4 questions, answered
Which sequence should the write-up follow?
The one your classroom teaches, and it is worth sending the checklist along with the instructions. Skills texts differ in how they break a procedure up and in what counts as a single line, so reasons written against another version can look wrong even when the reasoning is sound. Where two of your sources differ, note both and say which the document followed.
Does every line need its own citation?
Read the instructions, since some sections want a source on each line and others want them gathered by group. What stays true either way is that a reason with nothing behind it is what a marker questions first. Cite the skills text your course supplies rather than a video or a site you found while writing.
Can a sample replace my skills check-off?
No. The check-off is a performance in front of an instructor, and it belongs to you in the same way clinical hours do. What an example can show is the shape of the written half: how the columns line up, what a reason looks like when it is doing work, and where these documents usually thin out.
Where can I find a free NSG 122 Unit 4 sample paper?
The complete NSG 122 Unit 4 intake and output rationale is posted here free, every step with its reason and the accuracy cross-check. A rationale for a different skill can be prepared on request.
Why is intake and output measured in nursing?
It tracks fluid balance in patients at risk of dehydration or overload, guiding treatment. This sample explains each step of measuring it and why daily weight is used as a cross-check.