Scenario of a patient diagnosed with a second bowel resection surgery

Scenario of a patient diagnosed with a second bowel resection surgery

Mr. B was admitted for a second bowel resection surgery three days ago.  He also has a Foley catheter.  He has an IV of LR running at 125 mL/hr and is on a clear liquid diet.  In the last 12 hour shift (7a-7p), for breakfast Mr. B consumed 3 ½ oz of water with toast and eggs.  He consumed 50mL with his morning medications.  At 1100 the CNA records 435 mL from the Foley.  At lunch Mr. B had 1 cup of soup and 1 cup of jello.  At 1500 the CNA records 375 mL from the Foley.  At 1630 the nurse uses 350mL of sterile water to clean and empty the colostomy pouch.  A total of 525mL is measured.  Mr. B’s diet was advanced to full liquids for the evening meal.  He consumes 4oz of milk with 1 cup of cream soup and a saltine cracker.  At 1900 the CNA records 380mL from the Foley.

1.  What is the intake for the 12 hour shift?
2.  How do you obtain actual colostomy output in relation to the volume of sterile water used to clean the colostomy into the intake and output?
3.   What is the output for the 12 hour shift?
4.   What is the fluid balance for the 12 hour shift (Include sign and volume)?
5.   In your nursing judgment is the fluid balance appropriate, why?
6.  What are some expected assessment findings with this fluid balance?
7.  What is the appropriate nursing intervention?
8.  What is wrong with Mr. B’s evening meal?

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