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Surgery
A 40-year-old woman with inflammatory bowel disease has been receiving TPN for over 3 weeks. Workup reveals pelvic abscess. She undergoes exploratory laparotomy, resection of small bowel with anastomosis, and drainage of pelvic abscess. During surgery, TPN is maintained at the original rate of 125 mL/h. In the recovery room, the patient is found to have a urine output of 200 mL/h. CVP is 1, and laboratory results are Na,149;K,3.5;Cl,110;HCO3,18; BUN, 40; and creatinine, 1 mg/dL. Which of the following statements is true regarding this condition?
The patient's urine output is secondary to fluid overload during surgery.
The patient is in high-output renal failure.
Hyperosmolar-nonketotic coma will develop if the condition is not aggressively treated.
Diuresis is a normal response to stress of surgery.
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