Derek Chambers: Altered Fluid Balance Flashcards Preview

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Flashcards in Derek Chambers: Altered Fluid Balance Deck (11):
1

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

2

What is propanolol?

Beta blocker

3

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

4

What are the normal ranges for bloods?

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

5

What is the equipment required for a blood transfusion?

Pump
Blood giving set

6

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

7

Why is high potassium bad?

Could cause arrhythmias

8

What is bad about a high INR?

Higher risk of clotting

9

What is bad about low sodium?

Too low can lead to eventual coma

10

What are some of an altered fluid state?

Ascites
Alcohol related liver cirrhosis
Haematemesis

11

What is spironolactone?

Potassium sparing diuretic