to give or not to give, that is the question??8)

Specialties Emergency

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Specializes in critical care,flight nursing.

Man in the ER. Found on the ground by landlord. Last seen normal 10 days ago.Come in with slurred speech ( resolving), R side weakness ( uper worse then lower). Sodium 165. Urine output about 50 cc/h. Ct unsure between ICH vs tumor. Waiting for MRI. CK normal and no myoglobine in the urine but very dark tea colour. Order to infuse ,45 saline at 100 cc/h. Are you going with the order and why?

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Specializes in ICU/CCU, CVICU, Trauma.
Man in the ER. Found on the ground by landlord. Last seen normal 10 days ago.Come in with slurred speech ( resolving), R side weakness ( uper worse then lower). Sodium 165. Urine output about 50 cc/h. Ct unsure between ICH vs tumor. Waiting for MRI. CK normal and no myoglobine in the urine but very dark tea colour. Order to infuse ,45 saline at 100 cc/h. Are you going with the order and why?

Need other labs - Bun/Cr? Lytes? Serum osmo? If you cannot rule out a head bleed, DO NOT give dextrose!

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I would consider 1/4 saline with a sodium level of 165.

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Specializes in critical care,flight nursing.

Need other labs - Bun/Cr? Lytes? Serum osmo? If you cannot rule out a head bleed, DO NOT give dextrose!

*** Sorry, I was just covering that patient while the
RN
was on break. I believe no osmo was done. creatine was normal. Potassium was normal I believe. As for the dextrose comment. I was thought any hypotonic solution could cause shift of fluids into cell wich is a very bad idea with someone in is condition. The problem is that sodium.

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