Surgery Essay
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Surgery Essay
Discuss the management of oliguria Oliguria is the passage of less than 300mL of urine per 24 hours. Post-operatively the monitoring of urine output is of vital importance as it gives the medical personnel an idea of the fluid balance. The initial step to the management includes not only the monitoring of urine output, but also monitoring of other losses. Examples include the amounts drained from NG tubes, wound drains, and fistulae. By adding up the urine output, these other losses and considering approximate values for insensible losses: in sweat, lungs and faeces, one would know the negative water balance and hence the amount to fluid to replace. . In a patient pos-op, these losses may be increased by pyrexia for example. Each 1 degree rise in body temperature will require a 10% increase in body fluids administered. More fluid is needed in the case of vomiting or diarrhoea, and if the patient has just undergone an ileostomy, the amount of fluid lost should also be put in the fluid balance equation. Simply put, fluid intake must equal fluid output. Also, monitoring of U&E is important, because it is rarely the case were water alone is lost. Monitoring these results will give the doctor an idea of the serum electrolytes and should be used as a guide to treatment. Monitoring U&E is another way to check for renal function, to exclude renal causes of oliguria. Haematocrit should also be monitored.
Surgery Essay
Depending on the amount lost per day, the same amount of fluid must be given. One of the best solutions for fluid replacement is dextrose solution 5%. This solution is hypotonic, meaning it will be distributed throughout the fluid compartments, such that dextrose solution is equivalent to administering water, which distributes rapidly and evenly throughout the entire body fluid compartments. A dextrose saline solution can be administer to replace some of the lost sodium, depending on the U&E. Potassium, although lost, does not need to be replaced post-op as the serum concentration is high due to damaged cells. The loses should be monitored at all time, to correct as needed the intravenous fluids given. Also clinical examination will reveal signs of dehydration, such as dry lips and mouth. Monitoring weight is also a good idea. 31/01/09
Discuss the management of oliguria Oliguria is the passage of less than 300mL of urine per 24 hours. Post-operatively the monitoring of urine output is of vital importance as it gives the medical personnel an idea of the fluid balance. The initial step to the management includes not only the monitoring of urine output, but also monitoring of other losses. Examples include the amounts drained from NG tubes, wound drains, and fistulae. By adding up the urine output, these other losses and considering approximate values for insensible losses: in sweat, lungs and faeces, one would know the negative water balance and hence the amount to fluid to replace. . In a patient pos-op, these losses may be increased by pyrexia for example. Each 1 degree rise in body temperature will require a 10% increase in body fluids administered. More fluid is needed in the case of vomiting or diarrhoea, and if the patient has just undergone an ileostomy, the amount of fluid lost should also be put in the fluid balance equation. Simply put, fluid intake must equal fluid output. Also, monitoring of U&E is important, because it is rarely the case were water alone is lost. Monitoring these results will give the doctor an idea of the serum electrolytes and should be used as a guide to treatment. Monitoring U&E is another way to check for renal function, to exclude renal causes of oliguria. Haematocrit should also be monitored.
Surgery Essay
Depending on the amount lost per day, the same amount of fluid must be given. One of the best solutions for fluid replacement is dextrose solution 5%. This solution is hypotonic, meaning it will be distributed throughout the fluid compartments, such that dextrose solution is equivalent to administering water, which distributes rapidly and evenly throughout the entire body fluid compartments. A dextrose saline solution can be administer to replace some of the lost sodium, depending on the U&E. Potassium, although lost, does not need to be replaced post-op as the serum concentration is high due to damaged cells. The loses should be monitored at all time, to correct as needed the intravenous fluids given. Also clinical examination will reveal signs of dehydration, such as dry lips and mouth. Monitoring weight is also a good idea. 31/01/09
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