The patient may develop an ileus with fluid-filled loops of bowel that may result in prerenal azotemia and even acute tubular necrosis without overt shock. 3 Additional complications of electrolyte imbalance compound an already existing hypovolemia. Closely monitor the patient's vital signs, electrolyte values, and cardiac rhythm. Hypocalcemia also may be caused by third-spacing of intravascular volume. With the altered integrity of the vessel walls, fluids leak into the surrounding area.
Albumin makes up a large portion of the volume that leaks into the peritoneal space.
As calcium is bound to albumin, calcium leaks with the albumin, into the peritoneal area, compounding an already existing hypocalcemia. Assess for neuromuscular irritability, spasms, or tremors. The patient may need infusions of fresh frozen plasma or serum albumin. Monitor for arrhythmias, muscle weakness, and hypotension. Monitor for life-threatening arrhythmias.