An 87-year female, with a 3-day history of intermittent abdominal pain, abdomina

Question

An 87-year female, with a 3-day history of intermittent abdominal pain, abdominal bloating, and nausea and vomiting, came to the emergency department. She moved from Puerto Rico to join her grandson and his family only 2 months ago and speaks very little English. All information was obtained through her grandson. PMH includes an abdominal hysterectomy 12 years ago and an inguinal hernia repair 2years ago. She has nod history of coronary artery disease, diabetes or pulmonary disease. She takes only ibuprofen occasionally for mild arthritis. She has no known drug allergies (NKDA). Vital signs are: Blood Pressure 134/84, Pulse 84 beats/minute and regular, Respirations 20/minute and Temperature 97.2º F (36.2 ºC). An IV of D5 ½ NS with 20 mEq KCl at 100 mL/hour is started Nasal O2 at 2 L .With some difficulty a nasogastric tube (NGT) is inserted and connected to intermittent low wall suction. The NGT suddenly drains 575 mL and then slows to about 190 mL every hour. 3. Is this an expected amount of drainage from the NGT?

Explanation / Answer

Subsequently 3 days later of NGT suctioning the patient’s indications seem to be constant. She accounts sustained nausea with cramping, and occasionally very robust stomach discomfort. She appears progressively sluggish. When her lab reports are checked I can see her newest laboratory examination values and equate them to the admission information lab values. The values may show us Sodium decreasing, K decreased, Cl decreased, G also decreased, CO2 deceased, whereas BUN increased and finally Cr increased. The volume of 575 extracted is near to the normal volume that is minimum of 500 ml is usually excreted in an unobstructed stomach.

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