Derek Chambers: Altered Fluid Balance Flashcards

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1
Q

What is the pt history for Derek Chambers?

A
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
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2
Q

What is propanolol?

A

Beta blocker

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3
Q

What are the immediate priorities of care for Derek?

A
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
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4
Q

What are the normal ranges for bloods?

A

Hb: 13-18 g/dl (male)
11.5-15 g/dl (female)
INR:

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5
Q

What is the equipment required for a blood transfusion?

A

Pump

Blood giving set

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6
Q

Why are obs taken before, during and after a blood transfusion?

A

To provide a baseline

Ensures you know if the pt is reacting to the transfusion

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7
Q

Why is high potassium bad?

A

Could cause arrhythmias

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8
Q

What is bad about a high INR?

A

Higher risk of clotting

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9
Q

What is bad about low sodium?

A

Too low can lead to eventual coma

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10
Q

What are some of an altered fluid state?

A

Ascites
Alcohol related liver cirrhosis
Haematemesis

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11
Q

What is spironolactone?

A

Potassium sparing diuretic

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