A 12-year-old female undergoes an appendectomy • Post-op IVF D5 0.45% op IVF D5 0.45% NaCl @120 ml/hr. @120 ml/hr. • 12

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A 12-year-old female undergoes an appendectomy
• Post-op IVF D5 0.45% op IVF D5 0.45% NaCl @120 ml/hr. @120
ml/hr.
• 12 hrs later she develops headache, nausea, and later she
develops headache, nausea, and
vomiting Rx with Zofran and vomiting Rx with Zofran and Dilaudid
Dilaudid.
• 24 hr later she is confused and combative En later she is
confused and combative. En-route to route to
head CT she suffers a generalized tonic head CT she suffers a
generalized tonic-clonic seizure. seizure.
• Biochemistries reveal serum Na 122 Biochemistries reveal serum Na
122 mEq/L, K 4 /L, K 4 mEq/L,
BUN 5 mg/dl, BUN 5 mg/dl, creatinine creatinine 0.7 mg/dl,
osmolality 238 0.7 mg/dl, osmolality 238
mOsm/kg H20, urine osmolality 550 /kg H20, urine osmolality 550
mOsm/kg, urine /kg, urine
sodium plus potassium concentration 100 sodium plus potassium
concentration 100 mEq/L.
• How would you manage this? formulate 1 care plan for the
case.