no more a loser
Forum Guru
Topics: 140
Posts: 580
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70 kg man Post op urinary output in three consecutive hours 12cc, 17cc, 9cc. Whats the next step in dx?
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| galadusmle
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check urinary sodium to differentiate between dehydration and renal failure. Dehydration can cause low urinary sodium.
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| Delusional
Forum Elite
Topics: 41
Posts: 226
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or maybe even check Fe Na+ which shld be <1 in patients with Pre-renal cause or > 1 in Intra-renal failure.....
and in the meantime while at it i think it is right to send blood for BUN and creatinine.... to actually see if patient does have azotemia.....
Plus.....maybe insert a catheter to exclude an obstructive cause.....
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| no more a loser
Forum Guru
Topics: 140
Posts: 580
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yes u r both right
first u can check urinary Na+ conc. if pt's kidney is good, it will hold on to Na+ and H2O so if Na+ is less than 20, tx is fluids
n if kidney is problematic, it wont b holding on to Na+ so for Na+ above 20, cut back on fluids.
Also u can use FeNa+ if more than 1, failure of kidney
If FeNa+ less than 1, not enough fluids
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| shatal
Forum Newbie
Topics: 0
Posts: 3
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challenge him with iv fluids
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| Kevin
Forum Newbie
Topics: 2
Posts: 19
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practical experience - 90% hypovolumic
fluid challenge and bladder scan...........
plus creatinine for ARF..
___________________
Kevin
Australia!!!!
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| Columbia SC
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Check to see if the foley is patent first.
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| drrabines
Forum Elite
Topics: 90
Posts: 184
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Experience
- First check for ballon (vesical) maybe catheter obst
- no obstruct, IV cahllenge, Na fluid (if a central line placed check level)
- check electrolites, ABG
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