A 22-year-old hoy underwent appendicectomy operation and not passed urine even after 4 hours. All vitals are normal. The next step is
(A) Continue intravenous fluids + Catheterization # Low urine output (Oliguria/anuria)> When called to see a patient with diminishing or absent urine output, it is important to maintain a sense of perspective, in surgical paitients, the most comon cause of inadequate urine output is inadequate fluid input.> Prior to the administration of a fluid 'challenge' to confirm this, however, it is well worth ensuring that the urinary catheter is where it should be and functioning (i.e. not blocked).> Having done so, a small volume of fluid (500 ml in a previously fit adult, 250 ml in the elderly or those with cardiac morbidity) should be given intravenously over 30-60 minutes.> A subsequent rise in urine output, with sustained rise in jugular venous pressure (JVP) or central venous pressure (CVP) if available, indicates the correct diagnosis, and fluid administration should be increased accordingly.> No rise at all in either urine output or JVP/CVP suggests that the patient is significantly hypovolemic, requiring more special-is advice from the renal physicians.> Note that the administration of furosemide (frusemid), or similarly powerful diuretics, for the treatment of a low urine output is rarely appropriate in surgical patients unless they are in frank cardiac failure and have pulmonary oedema. Such treatment risks turning a simple case of surgical prerenal oliguria into acute renal failure.
Continue intravenous fluids + Catheterization
Foley's catheterization
Continue intravenous fluids + wait for another 6 hours
None of the above
Miscellaneous