Derek Chambers: Altered Fluid Balance Flashcards
What is the pt history for Derek Chambers?
47 yr old man Alcohol related liver cirrhosis 2 yrs Originally drank 60 units per week Abstinent for 18 months before relapsing to 8 cans of strong beer per day Episode of haematemesis Ascites Feeling light headed and agitated
What is propanolol?
Beta blocker
What are the immediate priorities of care for Derek?
Assess airway for patency ?suction, ?O2 Fluid challenge = 500ml bolus crystalloid (30mls per kg per hour) Full blood work up ?blood transfusion Cardiac monitor and ECG Bladder scan and catheterise Ultrasound and ascites tap Put in a wide bore cannula
What are the normal ranges for bloods?
Hb: 13-18 g/dl (male)
11.5-15 g/dl (female)
INR:
What is the equipment required for a blood transfusion?
Pump
Blood giving set
Why are obs taken before, during and after a blood transfusion?
To provide a baseline
Ensures you know if the pt is reacting to the transfusion
Why is high potassium bad?
Could cause arrhythmias
What is bad about a high INR?
Higher risk of clotting
What is bad about low sodium?
Too low can lead to eventual coma
What are some of an altered fluid state?
Ascites
Alcohol related liver cirrhosis
Haematemesis
What is spironolactone?
Potassium sparing diuretic