Education and care-planning support only — does not replace clinical judgment or local protocols.

🩺 CP-FLUID — Fluid Balance & Nutrition Score

Tracks intake, output, hydration and eating. · Group F Food and fluids · Links to: F1–F13, E9

Original tool, not yet validated. Pilot and review with clinicians before clinical decisions. Supports, but does not replace, clinical judgment, validated scales and local policy.

Patient

Date/Time

Nurse

Item	0	1	2
Oral intake today	0 · Eats >75% of meals	1 · Eats 25–75%	2 · Eats <25% or nil by mouth
Fluid balance (24 h)	0 · Within ±500 mL	1 · ±500–1000 mL	2 · More than ±1000 mL
Urine output	0 · ≥0.5 mL/kg/h	1 · Reduced, dark	2 · <0.5 mL/kg/h for 6 h
Hydration signs	0 · Moist mouth, normal skin	1 · Dry mouth, thirsty	2 · Sunken eyes, confused
Weight change (1 week)	0 · No change	1 · 1–2 kg change	2 · More than 2 kg
Swallowing / nausea	0 · No problem	1 · Mild nausea or slow swallow	2 · Vomiting or coughing on food

⚠ Red flags — escalate at once regardless of score

Urine <0.5 mL/kg/h for 6 h

Total: 0 — select a score for each item

Score	Level	Action
0–2	Low	Continue chart, encourage fluids
3–5	Medium	Strict input/output chart, daily weight, inform doctor
≥6	High	Doctor review today, dietitian / swallow referral

Nursing notes / action taken

⬇ Blank form (PDF)