Fluids

Question 1

42 year old woman. Admitted unwell.
Ileostomy output increased in last 48 hrs.
Almost 3 litres on day prior to admission.
Afebrile.
Clinically moderately volume depleted. BP 110/62.
managing to drink but anxious
she is unable to keep up due to nausea.

1. What are the goals of IV fluid therapy
2. What are you replacing
3. What else should you consider

Answer 1

1. Resuscitation and replacement
2. volume, Ileostomy secretions alkali (high in sodium and potassium)
3. • Nausea strong stimulus to ADH
     – Ileostomy output may fall rapidly.
     – Oral intake may vary
     – Patient may be able to calculate fluid balance