Fluid balance chart calculation after hip surgery
NMC OSCE practice station
Documentation & charts · 1 min to read · 10 min to perform
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Betty Ng, aged 70, had surgery to repair a broken hip yesterday.
Betty NgIs it about the fluid chart, nurse? I did drink what they brought me.
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You are the nurse on an orthopaedic ward at 15:00. Betty Ng, aged 70, had surgery to repair a broken hip yesterday. She weighs 70 kg. Her fluid balance chart for 07:00 to 15:00 is in the patient folder. Total her intake and output, work out the balance and her urine output per hour, and interpret what you find. Speak to Mrs Ng about her drinks and passing urine. Record your findings and your plan, showing your working.
What this station tests
- Add every intake and output line, including intravenous fluid, vomit and drains, then subtract output from intake.
- Urine output of less than 0.5 mL per kg per hour is a warning sign, even if the overall balance is positive.
- Ask about drinks and losses that were never written down and record the limitation.
- Interpret the chart alongside observations and examination, not on its own.
- Do not start or speed up intravenous fluids without a prescription; escalate for review.
Sources for the clinical content
- NICE CG174: Intravenous fluid therapy in adults in hospital
- Royal College of Physicians: National Early Warning Score (NEWS2)
- NICE NG148: Acute kidney injury: prevention, detection and management
- NMC: The Code
An original practice scenario with invented patients. Not an exam question.