post op fluid balance

Question 1

task

Answer 1

525

Question 2

the pt

Answer 2

NG tube in place with ng bag ; 600ml gastric juice
-IV cannulae ; full bag of 500ml % dextrose
-pulse and bP nad
-NG output : 600 ml
-IV 500ml NS since admission
NOTES
-500ml dextrose over 12 hours>500ml next 12 hours>then review
plastic gauze dressing over midline incion
adequate analgesia given

Question 3

hx

Answer 3

-pain? reasonably controlled
-UOP: not passed somce surgery
-do you want to pass urine? no
-lower abdomen palpation? not uncomfortable>do not feel the urge when compressed
-palpate upper abdomen painful due to sx
-look for signs fluid overload ; elevated JVP, peripheral edema, auscultate lungs
-signs of dehyudration : skin turgor, mucous emembranes

Question 4

presumptive dx

Answer 4

insufficient fluid and electrolyte replacement

Question 5

mx

Answer 5

1.IV fluid bolus
-500ml ns over 30-60 in>then r/v
-this stated and written
preferred fluid: NS, Hartmann, 4 dexwith 1/5 ns
-if USSS can measure bladder volume
2.UOP measure
-check for volume
-20ml/hr maintain
-check urinary sodium>if less20mmol in small amt urine>prerenal circulatory insufficiency confirmed