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Medicines management
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Kirsty Andrews, Martina O’Brien
Intravenous infusions are often used for fluid replacement therapy, to administer electrolytes such as sodium and potassium, as a medium for administering medicines and to deliver blood products. This section will enable you to understand how to calculate drip rates (an amount per unit of time) to ensure that the person receives the correct volume in a prescribed period of time.
Communicable, infectious and parasitic conditions
Published in Jackie Musgrave, Health and Wellbeing for Babies and Children, 2022
Dehydration and lack of appetite can be other effects of an infection. The symptoms of such infections can impact profoundly on young children especially if they do not understand why they feel unwell and especially if they do not have the vocabulary to express their feelings. Other consequences of infectious disease can include diarrhoea causing fluid loss which may need the replacement of electrolytes and fluid replacement. Dehydration is the biggest cause of death in children following diarrhoea and vomiting, especially in low-income countries. And although medication can be given to stop diarrhoea, there are side effects from the reduction in peristalsis which can lead to constipation. Other side-effects can include sepsis resulting in long-term damage and potentially in death.
Assisted conception
Published in David J Cahill, Practical Patient Management in Reproductive Medicine, 2019
The major pathologies associated with ovarian hyperstimulation syndrome are ovarian distension, a fluid shift from the intravascular space to the extravascular space giving rise to ascites and haemoconcentration, and pain and nausea. Management focuses on control of fluid balance, drainage of fluid collections, thrombosis prevention and, rarely, the need for intensive care in the event of a severely ill woman. Fluid replacement uses the oral route if tolerated, with intravenous fluids such as colloids rather than crystalloids, which will not stay in the intravascular space. Draining of ascites would be undertaken if this were causing severe discomfort and/or respiratory difficulties. The use of thromboprophylaxis should be universal for women admitted with OHSS and in the rare eventuality that clotting disorders and fluid management are difficult to control, then admission to an intensive care unit is advised (66).
Comparison between different anaesthesia techniques for protecting renal function in children undergoing radical nephrectomy
Published in Egyptian Journal of Anaesthesia, 2022
Hassan Saeed ELHoshy, Islam Mohamed ELBardan
All patients in all groups received a strict fluid replacement according to the standard fluid replacement administration guidelines during anaesthesia. At the end of surgery, patients were turned to supine position, oral secretion was aspirated then anaesthesia was discontinued and 100% oxygen was administrated. Muscle relaxants were reversed by neostigmine 0.04–0.08 mg/kg and atropine 0.02 mg/kg, and then the patients were extubated fully awake after return of protective airway reflexes and full muscle power. All patients were monitored in the ICU for 24 h after surgery. Serum creatinine, creatinine clearance, Cystatin C and NGAL was assessed 24 h before surgery, after induction of anaesthesia, 12 and 24 h postoperatively. Urine output was assessed intraoperatively every 1 h and postoperatively every 6 h for the first 24 h. Sedation was assessed during the first 5, 15, 30, and 60 mins using a five-point sedation scale [21]. Sedation level: alert = 0, occasionally drowsy = 1, drowsy and easy to arouse = 2, somnolent and difficult to arouse = 3, unarousable = 4. Postoperative pain was assessed using the objective pain score (OPS) [22] at the following time points: immediately on arrival to ICU, 2, 4, 8, 12, 16 and 24 h post-operatively.
Ad libitum drinking prevents dehydration during physical work in the heat when adhering to occupational heat stress recommendations
Published in Temperature, 2022
Hayden W. Hess, Macie L. Tarr, Tyler B. Baker, David Hostler, Zachary J. Schlader
The purpose of the present study was to test a unique hypothesis within a larger registered clinical trial (NCT04767347) that ad libitum drinking during heat stress recommendation compliant physical work in the heat would result in >2% body mass loss. In contrast to our hypothesis, ad libitum drinking prevented dehydration (i.e. <2% body mass loss; Figure 3a) in all experimental trials across a spectrum of exposures that varied markedly in WBGT and duration of physical work at a fixed metabolic heat production. These findings serve to challenge the premise that ad libitum drinking during prolonged exposure to heat stress will result in insufficient fluid replacement and subsequent progressive dehydration. Indeed, with all barriers removed (e.g. competing motivation, accessibility) ad libitum drinking staves off progressive dehydration during physical work in the heat.
Safety of treating acute liver injury and failure
Published in Expert Opinion on Drug Safety, 2022
Miren García-Cortés, Aida Ortega-Alonso, Raúl J. Andrade
Hypovolemia and shock may occur in patients with ALI and ALF. Hemodynamic evaluation and fluid replacement are crucial in this setting. Oral fluid intake is not feasible in many instances due to nausea and vomiting or intestinal pseudo obstruction in case high-dose opioids and sedatives are required due to high grade hepatic encephalopathy. Likewise, in the context of acute pancreatitis, which is occasionally present, particularly in APAP-DILI [1,5]. Fluid replacement should be guided by the clinical and biochemical status of the patient, which could be started with saline solutions, followed by other type of fluid solutions as in other critically ill patients [1]. Although there is scarce scientific evidence in the election of the type of fluid recommended in ALF, Critical care publications support the use of crystalloid over colloid fluids [11–14].