HTHSCI 2F03 Study Guide - Quiz Guide: Urinary Catheterization, Urinary Retention, Fluid Replacement
26 Dec 2020
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Ileum will adapt to limit fluid and electrolyte losses. Daily requirements + replaces losses, titrated to. Anuria usually = blocked or malsited catheter. Flush c 50ml ns and aspirate back. Look for cvp or uo response w/i minutes. Hx: balance chart, surgery, other losses, thirsty. Pcwp: indirect measure of left atrial pressure. Adh, aldosterone, cortisol na +h2o conservation. K+: tissue damage, transfusion, stress hormones. Use uo (aim>30ml/h) to guide fluid replacement but may need to maintenance fluids to 2l first 24h post-op. Avoid k+ supplementation for first 24h post-op. Ras activation na and h2o retention. Avoid fluids c na give 5% dextrose. Pts. have significant third space losses c loss of both water and electrolytes. Likely to need significantly more than standard daily requirements. Titrate rate of fluid therapy to clinical findings on serial examination. Inflammation significant fluid shift into the abdomen. Pts require aggressive fluid resuscitation and maintenance. 0. 9% ns c 20-40mm kcl added to each bag.
