nursingcutie

Thank you for input! Typically on our unit the MDs alternate between NS and LR for fluid boluses so that isn’t out of the ordinary for me. But again thanks for the input you really put me at ease.

DTV means due to void so after surgery they are supposed to void about 8 hrs later and a lot of the times with GYN patients once they void they can be discharged. But thanks for the kind words I just get really anxious that I didn’t do enough for the patient.

Hello I am new grad nurse thats only been working for about 6 months. When this particular incident happened I had been off orientation for about 2 months. I had this post op GYN 60 y/o f who just had a hysterectomy and was DTV at about 12pm and then be discharged. Now if you ever cared for GYN patients its really important for them to void after surgery to ensure the bladder was not damaged. The patient voided only about 50ml at about 10 pm which was 2 hours after the surgery with nothing in her bladder when bladder scanned. GYN likes at least 200 ml of urine for their post op patients and ordered a 500 ml bolus of LR on top of 75 ml/hr of LR for maintenance fluid. At about 11pm the patient only voided 100ml. GYN ordered another 500ml bolus and decided the patient needed to stay until morning to ensure she voided a good amount of urine. The patient kept voiding small amounts 50 or 100 ml. At about 12 pm she voided only 50 ml and when bladder scanned had about 200ml in the bladder. GYN ordered a foley insertion and the patient had a health output at first. Over the next few hours the patient only had about 50 ml of urine from the foley. GYN ordered another 500 ml bolus and said they would draw labs. I was a little skeptical about administering the bolus since this would be her third bolus and she has 75ml/hr maintenance fluid so I asked a senior nurse and she said to clarify with the doctor which I did. I even wrote a note identifying which doctor I spoke to before administering the bolus. The senior nurse told me it was okay as long as I clarified with the MD. To make a long story short the patients sodium level dropped to about 126 and she ended up having to stay another a night in the hospital for observation. She was fine and was discharged the next day but I can never forget about because I feel as though I caused it and I am always scared that she can sue me for something or that it could've been much worse. I just want to know could I have done something differently and how do I get over this feeling of anxiety and impending doom?