Derek Chambers: Altered Fluid Balance Flashcards
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
2
Q
What is propanolol?
A
Beta blocker
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
4
Q
What are the normal ranges for bloods?
A
Hb: 13-18 g/dl (male)
11.5-15 g/dl (female)
INR:
5
Q
What is the equipment required for a blood transfusion?
A
Pump
Blood giving set
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
7
Q
Why is high potassium bad?
A
Could cause arrhythmias
8
Q
What is bad about a high INR?
A
Higher risk of clotting
9
Q
What is bad about low sodium?
A
Too low can lead to eventual coma
10
Q
What are some of an altered fluid state?
A
Ascites
Alcohol related liver cirrhosis
Haematemesis
11
Q
What is spironolactone?
A
Potassium sparing diuretic
