High Fever and nausea and vomiting

Total Intake” and “Total Output.”Maranda O’Connor, a patient of Dr. Schmidt, was admitted to intensive care at Ram Hospital with a high fever and nausea and vomiting. A nasogastric (NG) tube was inserted and connected to suction drain-age. An intravenous (IV) infusion was started.

She was allowed clear liquids and ice chips by mouth.
a. IV of 5% D/W (dextrose in water) was absorbed as follows:10 am 200 mL 8 pm 450 mL 2 am 100 mL2 pm 550 mL 10 pm 100 mL 6 am 200 mL

b. The NG tube as irrigated with NS (normal saline) as follows:10 am 25 mL with 15 mL withdrawn 9 pm 35 mL with 25 mL withdrawn1 pm 30 mL with 20 mL withdrawn 2 am 15 mL with 5 mL withdrawn5 pm 15 mL 5 am 25 mL with 15 mL withdrawn

c. NG tube drainage was measured as follows:2 pm 550 mL greenish-brown10 pm 200 mL golden-brown6 am 450 mL greenish

d. Meals were as follows:8 am Breakfast: 1 glass juice, ½ small bowl broth, 1 small bowl jello12 Noon Lunch: 1 large glass juice, 1 soup bowl broth, 2 small bowls jello5 pm Supper: 1 glass juice, 1 soup bowl broth, 1 small bowl jello”

“e. Ice cubes were given as follows: (Note:1 ice cube = 5 mL.)1 ice cube at 9 am, 11 am, 3 pm, and 10 pm2 ice cubes at 12 Noon, 4 pm, 12 Midnight, and 2 am3 ice cubes at 2 pm and 5 pm

f. Ginger ale was given as follows:1 juice glass at 10 am and 7 pm½ water glass at 1 pm and 9 pm

g. Water was given as follows:½ water glass at 7 am and 6 pm1 water glass at 1 am and 5 am

h. Urine output was as follows:10 am 400 mL 10 pm Patient incontinent, qs (quantity sufficient) 1 pm 550 mL 1 am 500 mL 5 pm 400 mL 4 am 650 mL

i. Emesis was expelled as follows:9 am 200 mL clear liquid7 pm 300 mL brownish liquid

j. Stool was expelled as follows:8 am 1 formed brown stool7 pm 200 mL brown liquid2 am 300 mL brown liquid”