Cheng Sisi turned her head and saw Tanglou's handsome and harmless face, looking at her calculation steps seriously.

She pouted. After all, she was also a top student and replenished fluids according to basic principles. She looked at Tang Lou with some dissatisfaction: "Then I need to ask Dr. Xiao Tang for advice."

"Don't dare to take it, don't dare to take it."

Tanglou didn't hear the irony in Cheng Sisi's tone at all, and took Cheng Sisi's calculation paper and the case in the hands of the little nurse.

"First of all, we all know the important electrolytes that normal people need every day. The blood sodium concentration of normal people is 135~150 mmol/L, and the daily sodium requirement is 4.5 g; and the blood potassium concentration is 3.5~5.5 mmol/L.

, daily requirement: 3~6 g;

Followed by blood magnesium concentration? 0.75 ~ 1.25 mmol/L, blood calcium concentration? 2.25 ~ 2.75 mmol/L."

Cheng Sisi nodded after listening to Tang Lou's explanation, but these were the most basic and she knew it.

"Continue~"

Cheng Sisi still had some doubts about Tanglou. Could this be the latest strategy for chasing girls?

But I am not a brainless nymphomaniac, and I can’t tell you how to make him look good!

"Well, now that we know the normal values, we also need to understand the principles of fluid replenishment. First of all, let's start with sodium replenishment and the principle of salt replenishment."

Cheng Sisi interrupted Tang Lou: "I know this. When the serum sodium is <130 mmol/L, fluid replenishment is needed. First add 1/3-1/2 of the total amount. The so-called salt replenishment is sodium chloride, which is commonly used in clinical practice.

The infusion is 0.9% sodium chloride injection, also known as physiological saline. I also follow the calculation formula: sodium supplement amount (g) = [(142-blood sodium measurement value) x body weight x 0.6]? 17."

Cheng Sisi's head was almost close to Tang Lou's nose, and she took a pen and scratched the formula she used on the calculation paper.

Then, he raised his head and looked at Tanglou closely. As a proud student, he asked: "The patient's blood electrolytes were tested, and the blood sodium was 120 mmol/L. After bringing it in [(142-120)x80x0.6]?17≈

62(g), right?”

Cheng Sisi's breath hit Tanglou's face, but he was not distracted and was very academic:

"The formula is correct, and your calculation is correct, but don't you think 62g is a bit exaggerated?"

"Right is right, wrong is wrong, what is exaggeration? Medicine is only about rigor, not fantasy, Dr. Xiao Tang!"

Cheng Sisi said seriously that she had memorized this formula dozens of times and there was no way she could make any mistakes.

"You have forgotten the most critical principle, which is to replenish 1/3 to 1/2 of the total amount on the first day. If you replenish the full calculated amount, the patient's heart will not be able to bear it. But after all, this is your first time to replenish fluids.

You know, it’s normal, just experience it once and you’ll be fine.”

Tanglou explained.

Cheng Sisi opened her mouth slightly and thought about it for a moment. It seemed that such a sentence was indeed mentioned in a case class, but she didn't pay much attention to it at the time.

The proud body was slightly deflated and wanted to refute, but he was indeed negligent.

But looking at Tanglou, Cheng Sisi was a little confused. Didn't this guy say it was his first time encountering a rehydration case? Why did he start to guide him with such experience?

Knowing the principle of rehydration on the first day, Cheng Sisi used his ability to draw inferences from one instance and grabbed the calculation paper, recalculated, and then threw it to Tanglou: "Hey, what about this time?"

Tanglou smiled as he saw Cheng Sisi raise a nice eyebrow and look at her proudly, begging for praise.

"Basically, that's right, but there are still a few points to note."

Tanglou looked at it for a while, deliberately pretended to be serious, and said with some regret.

"Huh? Is there anything else wrong?"

Cheng Sisi grabbed the calculation paper with some disbelief, put her index finger to her mouth as usual, bit it lightly, and started checking the calculations with a frown.

"That's right?"

"The calculation result is correct, but the method of potassium supplementation is wrong."

Tanglou was no longer teasing Cheng Sisi, and explained rigorously: "The principle of potassium supplementation is that the potassium supplementation rate is 20 mmol/h; the potassium supplementation concentration is 3/1000 ml. You remember this correctly. But the one you chose is potassium chloride injection.

The method is also something that interns often overlook. Intravenous potassium supplementation is very painful and has low safety. Direct intravenous injection requires higher requirements. If the concentration is wrong, it can easily cause the patient to have a cardiac arrest."

"So, I suggest that the best potassium supplement solution is oral potassium supplement. Since the patient weighs 80kg, the postoperative electrolyte serum potassium is 2.5mmol/L. If calculated in detail, [(4.5-2.5)x80x0.4]?13.4

≈5 g, plus the daily requirement, it is also 8-12 g. You calculated 10g, no problem."

"Yes."

Cheng Sisi's eyes lit up. Since there was no rehydration plan, she didn't expect that potassium supplementation could be taken orally.

There was a subtle change in Cheng Sisi's mentality. She was very passionate about academics and was very open-minded.

He looked at Tanglou with more and more curiosity. This guy was obviously an intern, but he looked like he had seen countless people and had rich experience?

"The calcium supplement plan is fine. But you're missing something."

Tanglou stared into Cheng Sisi's eyes, smiled slyly, and paused deliberately.

"Tell me, what else is there?"

Cheng Sisi was now completely convinced of Tanglou and hurriedly asked.

"Rehydration, rehydration, are you really rehydrating? In addition to these electrolytes, patients have little energy after surgery. Especially after gastrointestinal surgery, they generally cannot eat normally for 1-3 days, so in addition to fluids and electrolytes, patients also need a lot

of energy.”

Cheng Sisi suddenly understood and blurted out: "I understand, we also need sugar-water compounds, amino acids, fat emulsions, trace elements, etc."

Tanglou touched his chin like a child and nodded.

"whee!"

"Shashasha~"

Cheng Sisi calculated again on the calculation paper, and then came up with a set of data: "Liquid volume 3365 ml, sodium supplement 21 (g), potassium supplement 10 g, daily glucose requirement 160 g, amino acids 96 g, triglycerides

56 g, 10 ml of trace element injection.”

Once we have the amount of fluid replenishment, of course it is not yet complete. We still need to come up with a rehydration plan, that is, specific reagents.

Cheng Sisi looked at Tang Lou's appearance as a worldly expert and felt a little competitive: "Dr. Xiao Tang, why don't you do some calculations and see if your plan is the same as mine."

After saying that, he took another piece of white paper and wanted to give it to Tanglou.

"Need not."

Tanglou tapped his temple with his handsome index finger.

"mental arithmetic?"

Cheng Sisi glanced at Tanglou in surprise, a little in disbelief, but it was reasonable. After all, there was a god of learning above the top academics.

Cheng Sisi looked at Tanglou's handsome face, and suddenly felt like others were looking at her for her high IQ and good looks.

"I'm so envious."

Cheng Sisi's heart quickened a few times, and she suddenly felt that Old Cheng's vision was still okay.

"Nurse, please write down the rehydration plan. It's a bit complicated."

Tanglou showed a sunny and confident smile to the little nurse. The latter nodded like a charming girl. He took out a pen and paper and got ready, fearing that he would miss a word.

"2 bags of 500 ml 10% glucose solution (100 g glucose), add 3 g potassium chloride and 9 g sodium chloride to the 1000 ml solution."

The little nurse nodded obediently and quickly remembered.

"2 bags of 500 ml glucose sodium chloride injection (50 g glucose, 9 g sodium chloride), add 3 g potassium chloride to the 1000 ml solution. Then add 5 g of glucose sodium chloride solution to each of the 2 bags.

ml Trace Element Injection, pay special attention to the slow intravenous infusion.”

"Okay." The little nurse wrote the words "Special Attention" and added a five-pointed star. Then she looked up at Tanglou's handsome face and said, "He's so handsome. Which department is he from? I haven't seen him before..."

When the nurse was distracted, Tang Lou continued to add:

"1250 ml of compound amino acid (15AA) solution (100 g of amino acids) contains 1.52 g of potassium ions and 2.5 g of sodium ions. An additional 2 g of potassium chloride can be added.

The last step is 250 ml of 20% fat emulsion (50 g of triglycerides).”

Cheng Sisi's eyes widened and she looked at the rehydration plan she had written in the middle. It was exactly the same. For the first time, she doubted her IQ.
Chapter completed!