7/31/2019 Mabes Fluid and Electrolyte Imbalances

1/15

Calh|ath

|z Tgsts

mh| g}acwatji Mcwjd _tatws

Calh|ath|z ]acwgs \a`ig J`tg|~|gtatjh`

_g|we Hsehcacjtz

^casea Hsehcacjtz

?>>

ehse(ki

_g|we Hsehcacjtz egasw|gs shdjwe oh`og`t|atjh`

^casea Hsehcacjtz |giwcatgs ADB |gcgasg mh| b |gsh|~tjh`

LW@ a`d Icwohsg bas a |hcg j` hsehcacjtz

J`o|gasj`i Hsehcacjtz "_g|we Gcgot|hcztgs 0 Yatg|*

M]D

_g}g|g dgbzd|atjh` M|gg yatg| chss

Djalgtgs j`sj~jdws

Bz~g|iczogeja

Bz~g|`at|geja

_t|hkg h| bgad j`fw|z

Dgo|gasj`i Hsehcacjtz "Yatg| 0 _g|we Gcgot|hcztgs*

M]G

H}g| bzd|atjh`

_JADB

Ad|g`ac J`swmmjojg`oz

Bz~h`at|gejaW|j`g Hsehcacjtz > ?>>

ehse(ki

Dgtg|ej`gd lz w|ga# o|gatj`j`g# a`d w|jo aojd

Ehst |gcjalcg j`djoath| hm w|j`g oh`og`t|atjh`

J`o|gasj`i Hsehcacjtz "Oh`og`t|atgd W|j`g*

M]D

_JADB

Oh`igstj}g bga|t majcw|g

Aojdhsjs

Dgo|gasj`i Hsehcacjtz "Djcwtgd W|j`g*

M]G

Djalgtgs

J`sj~jdws Bz~h`at|geja

Acdhstg|h`jse

^zgch`g~b|jtjs

Lchhd W|ga

@jt|hig`

"LW@*

1> ei(dc

?.= %9.< eehc(C

Eadg w~ hm w|ga "g`d ~|hdwot hm ~|htgj` egtalhcjse lz cj}g|*

Aej`h Aojd l|gakdhy` Aeeh`ja ehcgowcgs alsh|lgd j` lchhd

Aeeh`ja oh`}g|tgd th w|ga W|ga gro|gtgd tb|w w|j`g

J`djoatgs |g`ac mw`otjh`

J`o|gasgs ybg` |g`ac ~g|mwsjh` dgo|gasgs

Dgtg|ej`gs sg|we hsehcacjtz

Ammgots ~|htgj` a`d egtalhcjse statg

Maoth|s tbat J`o|gasgs LW@ Dgo|gasgd \g`ac Mw`otjh`

Dgbzd|atjh`

Mg}g|

J`o|gasg ~|htgj` j`takg

Eafh| _g|we

Gcgot|hcztgs

A~~|hrjeatg _g|we

Oh`og`t|atjh`

eGq(C

@h|eac ]acwg

eGq(C

@h|eac ]acwg

ei(dc

@h|eac ]acwg

eehc(C

_hdjwe 14< 1?7 147 1?7 147

^htassjwe 7 ?.7 7.> ?.7 7.>

Oacojwe 7 4.7 7.7

Jh`jvgd

2.= 1>.<

7/31/2019 Mabes Fluid and Electrolyte Imbalances

2/15

IJ lcggdj`i

_g~sjs

Maoth|s tbat Dgo|gasgs LW@

Oh`djtjh`s tbat gr~a`d mcwjd }hcweg

Bz~h`at|geja

H}g|bzd|atjh`

_JADB

ADB

Chy ^|htgj` Djgt _ta|}atjh`

_g|we O|gatj`j`g >.9 1.4ei(dc

= 1.>

eGq(

7/31/2019 Mabes Fluid and Electrolyte Imbalances

3/15

Eaz hoow| ach`g h| j` ohelj`atjh` yjtb htbg|

jelaca`ogs

@w|sj`i Djai`hsjs

Mcwjd ]hcweg Dgmjojt

Dgo|gasgd Oa|djao Hwt~wt

^htg`tjac Ohe~cjoatjh`6 Bz~h}hcgejo _bhok

Gtjhchijo Maoth|s

1. Dgo|gasgd mcwjd j`takg "caok hm aoogss th iaj` mcwjds#

a`h|grja# `awsga# je~aj|gd syacchyj`i# oh`mwsjh`#

dg~|gssjh`# j`ma`ts# gcdg|cz# ~bzsjoaccz - eg`taccz

dgljcjtatgd*

.:'

@aOc# Caotatgd \j`ig|s mh| bz~htg`sj}gs

Bz~hth`jo _hcwtjh` ">.47' @aOc*

mh| `h|ehtg`sj}gs

> > ec hm @__ r 17 ej`s mh|

|g`ac ~g|mwsjh` @h|eac \gswct6 j`o|gasgd WH# L^# a`d O]^

?. ^ba|eaohchijo Tbg|a~z

A`tjdja||bgacs mh| Dja||bga

A`tj%gegtjos mh| }hejtj`i

A`tj%~z|gtjos mh| mg}g|

@w|sj`i Ea`aigeg`t

1. Assgss a`d eh`jth| ~atjg`ts yjtb M]D ea`jmgstatjh`s

7/31/2019 Mabes Fluid and Electrolyte Imbalances

4/15

@w|sj`i Djai`hsjs

Mcwjd }hcweg grogss

\jsk mh| j`adgqwatg aj|yaz ocga|a`og

\jsk mh| je~aj|gd skj` j`tgi|jtz

Djstw|lgd lhdz jeaig

^htg`tjac ohe~cjoatjh`s

a. ^wceh`a|z Gdgea

l. Asojtgs mh|e hm gdgea ybg|gj` mcwjd js

aoowewcatgd j` ~g|jth`gac oa}jtz; gtjhchijo maoth|s

swob as `g~b|htjo sz`d|heg# sheg eacji`a`t

tweh|s# cj}g| oj||bhsjs; sbh|t`gss hm l|gatb a`d

dzs~`ga dwg th ~|gssw|g h` tbg dja~b|aie

Gtjhchijo Maoth|s

1. Grogssj}g j`takg hm djgta|z shdjwe

7/31/2019 Mabes Fluid and Electrolyte Imbalances

5/15

\giwcatgd lz tbj|st# ADB# a`d \g`j` A`ijhtg`sj`

Acdhstg|h`g _zstge

Acdhstg|h`g j`o|gasgs shdjwe a`d yatg| |gtg`tjh`

Jts oh`og`t|atjh` js tbg eafh| dgtg|ej`a`t hm GOM

}hcweg

_hdjwe j`o|gasgs oacojwe chss

Mw`otjh`s hm _hdjwe

1. ^|jea|z |giwcath| hm GOM }hcweg a`d oh`og`t|atjh`

.:'@aOc# C\*

`ht 0 1< eGq(C j`

7/31/2019 Mabes Fluid and Electrolyte Imbalances

6/15

@w|sj`i Djai`hsjs6 \jsk mh| J`fw|z

Gtjhchijo Maoth|s

a. _hdjwe Iaj`

Grogssj}g djgta|z shdjwe j`takg

Grogssj}g bz~g|th`jo J] mcwjds - g`tg|ac mggdj`is

Grogssj}g oh|tjohstg|hjd# shdjwe ljoa|lh`atg#

shdjwe obch|jdg# HTO d|wis

@ga| d|hy`j`i j` sga yatg|

l. Yatg| Chss

J`adgqwatg yatg| j`takg

Yatg| dg~|j}atjh` "~atjg`ts ybh oa`t ~g|ogj}g#

|gs~h`d# h| oheew`joatg tbj|st swob as gcdg|cz#

j`ma`ts# ohi`jtj}gcz je~aj|gd*

J`sg`sjlcg yatg| chssgs "bz~g|}g`tjcatjh`# mg}g|*

Bgat st|hkg

Yatg|z dja||bga

Djalgtgs j`sj~jdws

Ocj`joac Ea`jmgstatjh`s

Tge~# L^# B\# ^\

Tbj|st eaz lg je~aj|gd j` gcdg|cz a`d jcc ~atjg`ts

D|z# |gd# syhccg` th`iwg

D|z# stjokz ewohsa

D|z# mcwsbgd skj`

\gstcgss`gss a`d ygak`gss

@gw|hchijoac oba`igs j` sg}g|g oasgs

Calh|ath|z Data % Bgehoh`og`t|atjh

sg|we shdjwe cg}gcs 0147 eGq(C

sg|we a`d w|j`g hsehcacjtz

w|j`g s~gojmjo i|a}jtz

w|j`g hsehcacjtz j` Djalgtgs J`sj~jdws

Egdjoac Ea`aigeg`t

1. Djgta|z _hdjwe \gst|jotjh`

' hm K+ js

gro|gtgd tb|w kjd`gzs - ' js chst tb|w lhygc -

sygat.

Kjd`gzs |giwcatg ~htassjwe cg}gcs lz adfwstj`i tbg

aehw`t hm gro|gtgd w|j`g

Acdhstg|h`g j`o|gasgs ~htassjwe gro|gtjh`

7/31/2019 Mabes Fluid and Electrolyte Imbalances

7/15

As sg|we K+# sh dhgs jts cg}gc j` |g`ac twlwcg ogcc

J`swcj`bgc~s K+ eh}g j`th JOM

Tjsswg daeaig - aojdhsjs sbjmts ~htassjwe hwt hm ogccs.

Mw`otjh`s hm ^htassjwe

1. Eaj`taj`s JOM Hsehcacjtz

eGq(1>>eC

9. Eh`jth| WH. Adej`jstg| ~htassjwe amtg| adgqwatg WH

bas lgg` gstalcjsbgd. _th~ j`mwsjh` jm WH js 3ec(b|.

_g|we K+ cg}gcs oa` |jsg da`ig|hwscz j` hcjiw|ja

2. Adej`jstg| ~htassjwe wsj`i J] J`mwsjh` ^we~.DH @HT adej`jstg| lz J] ^W_B h| JE th a}hjd

|g~caogeg`t hm ~htassjwe qwjokcz

a. ^g|j~bg|ac J] Cj`g eGq(1>>ec; `h mastg|

tba` 1> eGq(b|; ~aj`mwc j` ~g|j~bg|ac }gj`s

l. Og`t|ac J] Oatbgtg| % 0 eGq(1>>ec

:. Oa|g j` gcdg|cz ybh ba}g chy ~htassjwe |gqwj|geg`ts

1>. Eh`jth| djijtacjs thrjojtz

_g|we ~htassjwe 07eGq(C ^htg`tjac ohe~cjoatjh`6 A||bztbejas# Oa|djao A||gst

@w|sj`i Djai`hsjs6 \jsk mh| J`fw|z

Gtjhchijo Maoth|s1. Wswaccz Jat|hig`jo h| t|gateg`t |gcatgd

7/31/2019 Mabes Fluid and Electrolyte Imbalances

8/15

7. Bz~hacdhstg|h`jse

=. Addjsh`s Djsgasg

9. Egtalhcjo Aojdhsjs "eh}geg`t hm K+ m|he JOM th GOM*

2. _g}g|g tjsswg t|awea# j`fw|z# - j`mgotjh`s

:. ^sgwdhbz~g|kacgeja "tjibt thw|`jqwgt ybjcg d|ayj`i

lchhd sae~cg# ea|kgd cgwkhozthsjs# tb|helhozthsjs#

d|ayj`i lchhd alh}g tbg sjtg ybjcg K+ js j`mwsj`i*

1>. T|a`smwsjh` hm aigd h| sth|gd lchhd th ~atjg`ts yjtb

je~aj|gd |g`ac mw`otjh`

11. ^htassjwe s~a|j`i djw|gtjos# ~htassjwe obch|jdg# AOG

j`bjljth|s# @_AJD_# lgta lchokg|s# bg~a|j`

Ocj`joac Ea`jmgstatjh`s "_(_*

1. Oa|djao oba`igs6 gmmgot h` ezhoa|djwe

Dzs|bztbeja "j||giwca| bga|tlgat*

]g`t|jowca| mjl|jccatjh` h| oa|djao sta`dstjcc

Je~aj|gd oa|djao dg~hca|jvatjh`

\g~hca|jvatjh` hoow|s m|gqwg`tcz

Taobzoa|dja L|adzoa|dja A||bztbejas

Oa|djao a||gst

7/31/2019 Mabes Fluid and Electrolyte Imbalances

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Mw`otjh`s

1. Eafh| st|wotw|ac ohe~h`g`t hm lh`gs - tggtb %%

Mh|eatjh` hm lh`gs a`d tggtb

. ^a`o|gatjtjs

11. \g`ac Majcw|g1

7/31/2019 Mabes Fluid and Electrolyte Imbalances

10/15

lgmh|g t|gatj`i bz~hoacogeja j` ~atjg`ts yjtb ob|h`jo

|g`ac majcw|g.

4. Adej`jstg| oawtjhwscz th ~atjg`ts |gogj}j`i djijtacjs as jt

~htg`tjatgs tbg aotjh` hm djijtacjs

7. Tbjavjdg djw|gtjos th dgo|gasg gro|gtjh` hm oacojwe

@w|sj`i Ea`aigeg`t

1. Hlsg|}g ~atjg`t mh| bz~hoacoageja ea`jmgstatjh`s

. _gjvw|g ~|goawtjh`

11. Hlsg|}g djijtacjs thrjojtz

_g|we oacojwe 01>.< ei(dc

^htg`tjac ohe~cjoatjh`6 A||ztbejas

Gtjhchijo Maoth|s

1. Bz~g|~a|atbz|hjdjse"^TB |gcgasg*

7/31/2019 Mabes Fluid and Electrolyte Imbalances

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1. Ohg`vzeg j` oa|lhbzd|atg a`d ~|htgj`

egtalhcjse

.=< eehc(C*

Asshojatgd yjtb bz~hkacgeja a`d bz~hoacogeja

Gtjhchijo Maoth|s

IJ Chssgs "j.g. ~|hch`igd `ashiast|jo swotjh`j`i#

j`tgstj`ac mjstwcas# dja||bga*

Djs|w~tjh` j` seacc lhygc mw`otjh` lgoawsg jts tbg

eafh| sjtg hm eai`gsjwe alsh|~tjh` "j.g. j`tgstj`ac

|gsgotjh`# j`mcaeeath|z lhygc djsgasg*

Acohbhc yjtbd|ayac; ob|h`jo acohbhcjse

G`tg|ac ( ~a|g`tg|ac mggdj`i dgmjojg`t j`

eai`gsjwe

\a~jd adej`jst|atjh` hm ojt|atgd lchhd

Egdjoatjh`s6 aej`hiczohsjdgs# ozochs~h|j`g#

ojs~catj`# djijtacjs# ae~bhtg|joj` Hoow|s j` Djalgtjo Kgthaojdhsjs# j`swcj` tbg|a~z

^|gi`a`oz# caotatjh`# lw|`s# bz~htbg|eja

Ocj`joac Ea`jmgstatjh`s

1. @gw|hewsowca| oba`igs

`gw|hewsowca| bz~g|grojtaljcjtz yjtb ewsocg

ygak`gss# t|geh|s# - atbgthjd eh}geg`ts

"schy# j`}hcw`ta|z tyjstj`i*

T|geh|s# }g|tjih# `zstaiews# ig`g|acjvgd h|

mhoac sgjvw|gs# ca|z`igac st|jdh|# "+* ob}hstgks

a`d "+* t|hwssgawss sji`

ei(ej` H\ =9 eGq(2b|s

@w|sj`i Ea`aigeg`t

1. Assgss a`d eh`jth| at |jsk ~atjg`ts

>ec ( 4b|s

=. Eh`jth| J] eai`gsjwe |atg

\gadz Oacojwe Icwoh`atg th t|gat Ei thrjojtz

_gjvw|g ~|goawtjh`

Mh| Acohbhcjos# ~|h}jdg tgaobj`i# ohw`sgccj`i# a`d

~hssjlcg |gmg||ac th acohbhc alstj`g`og ~|hi|aes.

Eh`jth| a`d t|gat ~htg`tjac bz~hoacogeja

_g|we cg}gc 0

7/31/2019 Mabes Fluid and Electrolyte Imbalances

12/15

Grogssj}g adej`jst|atjh` hm Eai`gsjwe

Grogssj}g wsg hm eai`gsjwe a`taojds a`d caratj}gs "jg. Eaachr# ejck hm eai`gsja*

Djalgtjo Kgthaojdhsjs

Ad|g`ac j`swmmjojg`oz

Addjsh`s djsgasg

Egdjoatjh`s tbat dgo|gasg IJ ehtjcjtz "j.g. H~jhjds# A`tj%obhcj`g|ijos*

Ocj`joac Ea`jmgstatjh`s

Bz~htg`sjh`#L|adzoa|dja# \gs~j|ath|z Djst|gss "\gs~j|ath|z dg~|gssjh`*

_hmt tjsswg oacojmjoatjh`

Maojac mcwsbj`i

Bz~haotj}g h| djej`jsbgd |gmcgrgs# ewsocg ygak`gss# ~a|aczsjs

Cgtba|iz# Djmmjowctz j` s~gakj`i "DZ_A\TBJA*

^catgcgt ocwe~j`i a`d dgcazgd tb|helj` mh|eatjh`

Calh|ath|z Data

_g|we oacojwe 0

7/31/2019 Mabes Fluid and Electrolyte Imbalances

13/15

Mhhd _hw|ogs

1. ejck a`d ejck ~|hdwots "jg. ba|d obggsg# o|gaes*

7/31/2019 Mabes Fluid and Electrolyte Imbalances

14/15

BZ^HOBCH\GEJA

Obch|j`g dgmjojt

bz~g|th`jojtz a`d

tgta`z

_bacchy#

dg~|gssgd l|gatbj`i

Wswaccz asshojatgd

yjtb bz~h`at|geja

a`d jts oba|aotg|jstjo

sze~thes# swob as

ewsocg ygak`gss#

a`d tyjtobj`i

obch|jdg

3:2eGq(C

_g|we ~B

09.47

"sw~~h|tj}g

}acwg*

_g|we OH.47'* shcwtjh` th |g~caog obch|jdg.

7/31/2019 Mabes Fluid and Electrolyte Imbalances

15/15

Jshth`jo

>.>:'@aOc "^@__*

D7Y

D7@__

Caotatgd \j`ig|s

Ogcc

}hcweg

|geaj`s

tbg saeg

Mcwjd eh}gs gqwaccz lgtygg`

ohe~a|teg`ts

Bz~hth`jo

>.47' @aOc

Mcwjd

eh}gs j`th \LO oawsj`i

ogcc |w~tw|g "bgehczsjs*

Mcwjd eh}gs m|he }asowca| s~aog

"~casea* a`d g`tg| tbg ogccs

Bz~g|th`jo

D7C\

7' Dgrt|hsg j`

>.47_acj`g7' Dgrt|hsg j` >.:

_acj`g

D1>Y Mcwjd eh}gs hwt hm tbg ogcc

oawsj`i o|g`atjh`

"sb|j`kj`i* hm \LOMcwjd js ~wccgd hwt hm tbg ogccs

a`d j`th tbg }asowca| szstge# sh

j`t|a}asowca| }hcweg