Surgical trauma Fluid shift from intracellular

to extracellular space

2+ bipedal edema

Capillary leakage ↓ affinity of RBC to O2

↑ abdominal girth
(102 cm)

discomfort Prolonged hospitalization

Fatigue

↑ pH, ↑ paCO2, ↑ HCO3- ↑ loss of albumin Monotonous environment

Use of loop diuretics

Abdominal girth: 105 cm Flattened/ inverted
diaphragm

(+) fluid wave

Compromised breathing

Dull upon percussion on

all four quadrants

Soft, globular, non- ↓ Hgb, Hct TAHBSO

tender abdomen
 Diminished breath sounds ↑ CEA, CA-125 Jackson-Pratt drain
bilateral lower lung fields insertion

Asymmetrical chest ↑ neutrophils

expansion; lag on left chest Chest tube thoracostomy

Asymmetrical tactile ↓ lymphocytes

fremitus

Dull upon percussion at ↑ platelet count

bilateral lower lung fields

dyspnea ↑ bacteria, mucus thread

Urinary frequency; ↑ pH, ↓ paCO2, ↓ HCO3-

urgency

Feeling of heaviness in ↓K
pelvic area

Pale palebral conjunctiva ↓ Ca

2+ bipedal edema ↓ albumin

Muscle cramps Yellow, slightly hazy

pleural fluid

General weakness ↑ total protein, RBC, WBC

Muscle cramps ↑ respiratory rate

 Age: 51 y/0 Immunocompression ↑ thoracic cavity size and ↓
lung size

Maternal history: 65P5

Compression of stomach Lung tissue compression

(-) contraceptive use

Low socioeconomic status

Loss of appetite ↓ lung expansion

Improper diet causing

nutritional deficiencies
↓ intake of Vit B ↓ partial pressure of PaCO2
stress

Hormonal imbalances ↓ Intake of Vit B12 ↑ bicarbonate concentration

to PaCO2

Suppression of FSH and LH Proliferate to lining of ↑ pH level

that helps mature ovarian peritoneum
follicles

Altered maturation of Blockage of lymphatic ↑ intracellular shifts of ions

system in exhange for H＋ions
ovarian follicles

Abnormal proliferation of Irritation of peritoneal lining ↑ binding of calcium ions to

ovarian follicles plasma proteins

Follicles fail to ovulate and Accumulation of fluid in the ↓ percentage of ionized

undergo atresia peritoneal cavity calcium