Senario Help

[paradise22]

Hello there everyone, I need some help with this senario.

Miss P has a acute bowel obstruction

Currently Nil By Mouth.

To have Hartmans Solution 1000mls over 6 hrs-followed by 1000ml dextrose/saline over 8 hrs.

0800 am IV Hartmans started.

1015 am Miss P vomits 200ml

1300 voids 120ml urine

1400hr 850ml drainage from naso-gastric bag is emptied.

What would be your nursing actions be with regards to Miss P's fluid balance status.

[grandee3]

TOTALLY OUT OF LINE!!!!! and the name calling is childish.:angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire :angryfire

[rn/writer, RN]

No one should be name calling. If you think someone is out of line, report the post (using this icon ) and let the moderators handle the situation.

To the OP: I thought the same thing as several others--that you were asking for homework assistance. A simple clarification would have helped. No need to attack and insult someone for misunderstanding.

To everyone: Let's get past the initial confusion and move on.

I learned something from this thread already. Hartman's solution = Lactated Ringer's.

[cheshirecat]

We have Hartmanns solution over here (UK) too so it may be a Brit/Aussie thing.

Right, has the patient got a foleys in? If not put one in right away and hrly measurements.

Check bloods, keep a close eye on pottasium.

Put another venflon in.

Check vitals.

I'm guessing this patient is grossly dehydrated and fluid and electrolytes need to be improved before getting this patient to theatre.

Have you checked med notes to check for heart disease etc.

[wonderbee, BSN, RN]

We have Hartmanns solution over here (UK) too so it may be a Brit/Aussie thing.

Right, has the patient got a foleys in? If not put one in right away and hrly measurements.

Check bloods, keep a close eye on pottasium.

Put another venflon in.

Check vitals.

I'm guessing this patient is grossly dehydrated and fluid and electrolytes need to be improved before getting this patient to theatre.

Have you checked med notes to check for heart disease etc.

Agreed. Continue to assess bowel sounds for decreasing activity at site of obstruction and for pain. Notify MD for orders for labs and possibly a CT. A completely obstructed bowel trumps lytes imbalance. Lytes can be replaced during OR or on the way. Also what about kidney fuction? Check creatinine. Don't want to fluid overload in the face of kidneys going south. Treat for pain and Zofran NG for nausea if not completely obstructed. Make sure pt. has at least two patent IV accesses in case pt. needs bolus fluid recussitation.

[cheshirecat]

May I ask why you needed this help?

[grandee3]

Thank you Miranda, I learned something too, LR is also called Hartman's in some parts of the country.

I have learned so much from this site over the last few years.

[KIAN]

I have a question about the scenerio. She had 1000ml in 6 hours and 1170 out in those 6 hours. Did I interpret that right or am I missing something? She certainly wouldn't be fluid overloaded so I guess I would need some information regarding her hydration status.

Really want to know.

[rn/writer, RN]

The OP has indicated that she is no longer interested in this topic and has chosen to do it in a way that is disrespectful to other posters.

Thank you to everyone who tried to help.

This thread is now closed.