History of fall

Specialties MICU

Published

History of fall

76 years old male patient was admitted in ICU with history of fall from height , He is known case of un control Diabetes mellitus type 2, He received 6 pint IV fluids in A&E ,His Blood Pressure still in lower side 80/40 mmHg , Hemoglobin was 8.8 g/dl ,nine unit O positive whole blood was transfused during night ,in the morning patient complained of abdominal distention , the enlarge meant of abdomen was increased daily ,Hb increased to 13.1g/dl , Doctor was prescribed 30mg of tab dulcolax and soap enema was given and kept patient NPO ,but still bowel not open ,USG abdomen and CT scan of abdomen and pelvis was in normal limit .

My question is does blood transfusion of nine unit which was given fast can cause abdominal distension and how ?

:eek: :roll

Thanks.:confused:

Hi sweetnurse,

It seems to me that you may be a student nurse from the questions you are asking, many at the same time. It also sounds as though you are doing an ICU rotation. If I am wrong, I will apologize, but, if I am right I think it only fair to yourself and your learning process to do some research and find the answers on your own. I feel that by coming here and getting answers to your questions you may be shorting yourself some knowledge.

Yes, coming here and asking the questions will get you the right answers, but will you learn anything at all from the process?

And if I am wrong about you being a student I will apologize up front. It just seems that more and more theses boards are a way for many of our up and coming nurses to take the easy way out.

bob

2 nd career RN :Hi

You should not say what ever you have post and copy it 5 times in the board , you don't know who I am and you can't make judgment about me from my question . I'm Registered Nurse working in ICU since one year , I'm not student nurse dewing research or rotation in ICU , I have more interesting in reading and learning more about nursing care and practices in the would and how the nurse can give the best quality patient care in correct manner to save both nurse and patient .I have post my question because I thought other nurse will get benefit from it even if I knew the answer , but that doesn't mean dewing homework by posting my question ,I think if you know the answer and you are interesting to chairing us your opinion regarding that topic will be better instead of writhing report about me...who I am ?.Now you are wasted your time and my times also to writhe for you post reply ,better to keep the place for writhing some thing that others can get benefit from it . * I don't know if my question is too difficult , So no body could answer it .

:chuckle

In answer to the original question, I have never experience in ED or ICU a pt w/distended abd r/t blood transfusion [unless there were other factors, ileus, liver failure, etc]

A comment on the tone of the last two entries:

Please let's try to behave professionally, there are enough places one can go and throw mud at eachother.

I have enjoyed this site because there is genuine concern and support of eachother, an interest in mentoring critical care nurses.

PLEASE Let's keep it that way.

It is possible that the gentleman had ascites (fluid in the abdomen). Did the girth diminish?

Specializes in ER.

You know I thought it was a good question, does anyone know the answer?

I've given a lot of transfusions over the years and have never seen abdominal distention as a result. I did have a patient years ago (6 or 7 years ago), who had a perforated bowel. This man's abdomen got more distended by the day. We didn't have an MRI on site yet and they hesitated bring anyone out of the confines of the hospital for an MRI a mile or so away. We sent this poor slob to CT Scan daily for about a week. CT's were always negative, just showed some fluid but no where near enough to justify his ever increasing abd. girth. Finally we (nursing staff) harassed the doctors on the case (You know death by multiple consutations-15 doctors and no one is looking at the whole picture) to get an ultrasound of the abd and lo and behold that was how they found he had a perf'd colon and 3 liters, THAT"S RIGHT, 3 liters of stool in his gut that was not picked up by at least 5 CT's. That was the first and last time I saw a case like that.

Did they check your patient for C Diff?

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