acid base fluids and electrolytes

... Instant Access: Acid- Base, Fluids, and Electrolytes Notice Medicine is an ever-changing science As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy ... books and websites, please click here To my wife Sheli, my parents Robert Sr and Nancy, my son Rob, and my brothers Steven and Fred, whose help and support are invaluable in both my life and career ... ACIDOSIS DINKAR KAW AND JOSEPH I SHAPIRO 171 METABOLIC ALKALOSIS DINKAR KAW AND JOSEPH I SHAPIRO 249 vii viii CONTENTS RESPIRATORY AND MIXED ACID- BASE DISTURBANCES YOUNGSOOK YOON AND JOSEPH I SHAPIRO...

Ngày tải lên: 12/08/2014, 05:21

... peptide, prostaglandins, and endothelin) • Physical properties (mean arterial pressure, peritubular capillary pressure, and renal interstitial pressure) affect handling of Na+ and water Na+ reabsorption ... Amiloride and triamterene can cause nausea and vomiting, rarely a metabolic acidosis and hyponatremia may occur Amiloride promotes glucose intolerance, while triamterene causes megaloblastic anemia and ... Exacerbates CHF, induces hyponatremia, and causes a hyperoncotic syndrome ■ Contraindicated in patients with CHF and moderate to severe kidney disease Nausea and vomiting, and headache are adverse effects...

Ngày tải lên: 12/08/2014, 05:21

... Figure 6–4 Paradoxical Intracellular Acidosis 248 METABOLIC ACIDOSIS 175 ACID- BASE CHEMISTRY AND BIOLOGY TABLE 6–1: General Principles of Acid- Base Homeostasis Acid- base homeostasis consists of the ... of nonvolatile acids and bases and the ingestion of a normal “Western diet” to maintain acid- base homeostasis the kidney must excrete this acid load The role of the kidney in acid- base homeostasis ... simply examines the initial substrates and final products To this, it is helpful to think of acids and bases as “lewis” acids and bases; in other words, to consider acids as electron acceptors rather...

Ngày tải lên: 12/08/2014, 05:21

... RESPIRATORY AND MIXED ACID- BASE DISTURBANCES Figure 8–2 Use of the Anion Gap in Evaluation 303 Figure 8–3 Acid- Base Nomogram 304 8–10 Syndromes Commonly Associated with Mixed Acid- Base Disorders ... significantly increased SAG 304 RESPIRATORY AND MIXED ACID- BASE DISTURBANCES FIGURE 8–3: Acid- Base Nomogram A second approach to the evaluation of mixed acid- base disturbances involves the use of a ... chronic compensation RESPIRATORY AND MIXED ACID- BASE DISTURBANCES 295 TABLE 8–5 (Continued) As PaCO2 increases and arterial pH decreases, renal acid excretion and bicarbonate retention become...

Ngày tải lên: 12/08/2014, 05:21

... FGF-23, a 251-amino acid protein, is secreted and processed at a cleavage site into inactive N- and C-terminal fragments; mutations in ADHR occur at the proteolytic site and prevent cleavage ... intolerance, and Lowe’s syndrome Acquired—Multiple myeloma, renal transplantation, and drugs Drugs—Ifosfamide, streptozocin, tetracyclines, valproic acid, ddI, cidofovir, adefovir, tenofovir, and ranitidine ... in the face of a normal serum glucose concentration, and aminoaciduria Less commonly patients may also have proximal renal tubular acidosis and hypokalemia Diagnosis A urinalysis for glycosuria...

Ngày tải lên: 12/08/2014, 05:21

... 243, 286 acid- base balance assessment approach of patients, 189–192 bicarbonate reclamation, 182–183 new bicarbonate production, distal nephron, 184 acid- base biology/chemistry acid- base balance ... 107 and DCT diuretics, 115 and diuretic resistance, 118, 120 encephalopathy risks, 115 and K+ balance disorders, 42 and mineralocorticoid receptor blockers, 116 and Na+ balance disorders, 42 and ... 37, 39, 150, 153, 265, 278, 284 lithium and hypercalcemia, 320, 331 and K+ balance disorders, 150 and metabolic acidosis, 200 and nephrogenic DI, 92, 101 and serum magnesium disorders, 442 loop...

Ngày tải lên: 12/08/2014, 05:21

... (HYPERCHLOREMIC METABOLIC ACIDOSIS) LÀ GÌ ? Một nhiễm toan tăng clo-huyết (hyperchloremic metabolic acidosis) tên gọi khác để nhiễm toan với AG bình thường (normal gap acidosis) Nếu AG bình thường, ... U = Uremia (suy thận) D = DKA (diabetic ketoacidosis) hay AKA (alcoolic ketoacidosis) P = Paraldehyde, phenformin I = INH (Isoniazid) Sắt L = Lactic acidosis E = Ethylene glycol S= Salicylate, ... Acetazolamide ; Acid (ví dụ hydrochloric) ; Bệnh Addison R : Renal tubular acidosis (nhiễm toan ống thận) D : Diarrhea U : Uterosigmoidostomy (mở thông niệu quản-xích ma) P : Pancreatic fistula and drainage...

Ngày tải lên: 13/07/2014, 15:20

... (HYPERCHLOREMIC METABOLIC ACIDOSIS) LÀ GÌ ? Một nhiễm toan tăng clo-huyết (hyperchloremic metabolic acidosis) tên gọi khác để nhiễm toan với AG bình thường (normal gap acidosis) Nếu AG bình thường, ... U = Uremia (suy thận) D = DKA (diabetic ketoacidosis) hay AKA (alcoolic ketoacidosis) P = Paraldehyde, phenformin I = INH (Isoniazid) Sắt L = Lactic acidosis E = Ethylene glycol S = Salicylate, ... Acetazolamide ; Acid (ví dụ hydrochloric) ; Bệnh Addison R : Renal tubular acidosis (nhiễm toan ống thận) D : Diarrhea U : Uterosigmoidostomy (mở thông niệu quản-xích ma) P : Pancreatic fistula and drainage...

Ngày tải lên: 26/07/2014, 17:21

... 16 17 Key Elements Underlying Acid Base Balance Learning Objectives Overview What Is pH? Acids Bases Acid and Base Balance 19 19 20 20 21 22 23 CHAPTER x Fluids and Electrolytes Demystified Regulation ... with that pathology Fluids and Electrolytes Demystified is designed to make the concepts associated with fluid, electrolyte, and acid base balance and imbalance clear and understandable The key to ... there is often duplication and overlap between electrolyte and acid base imbalances In Fluids and Electrolytes Demystified, the normal functions are discussed to provide baseline data The concepts...

Ngày tải lên: 11/08/2014, 17:21

... Click here for terms of use 20 Fluids and Electrolytes Demystified Distinguish between strong acids and weak acids and strong bases and weak bases Define buffer and explain how the buffer systems ... produce acidic products such as • Ketone bodies • Phosphoric acid 22 Fluids and Electrolytes Demystified • Carbonic acid • Lactic acid These acidic products are constantly entering the body fluids, and ... function and fluid management Neuromuscular and cardiac function Bone structure, neuromuscular function, and clotting Active transport of Na+ and K+ and neuromuscular function Osmolality and acid base...

Ngày tải lên: 11/08/2014, 17:21

... phosphates, and others) The normal range of base excess is Ϯ2 mEq/L A negative base excess (–3 mEq/L or less) indicates a deficit of base and a metabolic acidosis (i.e., ketoacidosis or lactic acidosis) ... failure is present) 34 Fluids and Electrolytes Demystified Laboratory Tests Indicating Acid Base Imbalance The most common laboratory tests performed to determine acid base status include an arterial ... determination—pH, Pco2, and HCO3 levels, as well as Po2 because hypoxia can result in lactic acidosis, venous serum CO2, electrolytes because electrolyte levels are affected by acid or base states, and urine...

Ngày tải lên: 11/08/2014, 17:21

... with hydration, nutrition, electrolytes, and acid base balance) • Diarrhea (causing loss of fluids and nutrients including electrolytes) • Malabsorption (causing fluid and nutrient loss) • Bleeding ... long as possible and sends messages to stimulate the individual to take in 68 Fluids and Electrolytes Demystified fluids, such as thirst, and to reserve fluids through the kidneys and bowel If fluid ... fluid in) Figure 4–1 Vein Relationship between hydrostatic pressure and oncotic pressure in the arteries and veins 66 Fluids and Electrolytes Demystified Hypovolemia Hypovolemia is a deficiency of...

Ngày tải lên: 11/08/2014, 17:21

... new and significant symptoms and possible sources of the imbalance • Intake and output are critical to detection of sodium and fluid imbalances and to implement interventions • All intake and output ... levels of other electrolytes and acid base balance In alkalosis, for example, potassium may shift out of the cell as hydrogen ions shift into the cell to buffer the excessive acid, and when serum ... blood draw (tourniquet, hand clenching) 102 Fluids and Electrolytes Demystified and feet, weakness, or a flaccid paralysis that is characteristic of both hyperkalemia and hypokalemia NURSING IMPLICATIONS...

Ngày tải lên: 11/08/2014, 17:21

... Furthermore, foods high in phytic acid (e.g., spinach, sweet potatoes, and beans) and oxalic acids (e.g., whole-grain breads, seeds, and nuts) may bind to calcium and prevent its optimal absorption ... complaints may include numbness and/ or tingling around the mouth or in the hands and feet; muscles spasms in the feet, face, and hands that in more severe cases may expand to tetany (uncontrolled ... secretion, perspiration, vomiting, diarrhea, fasting, and starvation • Potassium imbalances can lead to acid base and other electrolyte imbalances, and if not corrected quickly, potassium imbalance...

Ngày tải lên: 11/08/2014, 17:21

... carbonic acid (i.e., hydrogen ions) is 20:1, any increased acid content changes the ratio, resulting in an acidotic state CHAPTER 10 Acid Base Imbalances 149 TYPES AND CAUSES OF ACIDOSIS The lungs and ... and contrast causes, manifestations, and treatments for hypophosphatemia and hyperphosphatemia Copyright © 2008 by The McGraw-Hill Companies, Inc Click here for terms of use 136 Fluids and Electrolytes ... 10 Acid Base Imbalances Learning Objectives At the end of this chapter, the student will be able to Compare and contrast acidosis with alkalosis Identify the source of acidosis or alkalosis based...

Ngày tải lên: 11/08/2014, 17:21

... from the glomerulus and toward the renal medulla and collecting ducts 170 Fluids and Electrolytes Demystified Fluids, electrolytes, and bicarbonate are secreted, reabsorbed, and excreted in different ... Resistance to trauma and infection by keeping most trauma and friction at the surface and keeping organisms at the surface and away from the bloodstream 176 Fluids and Electrolytes Demystified ... concerns • Gastric and intestinal mucosae atrophy with decreased production of acid and intrinsic factor needed for absorption of vitamin B12 These changes result in acid base imbalance and potential...

Ngày tải lên: 11/08/2014, 17:21

... balance of the body and also affect electrolytes and acid base balance is focused on restoring and maintaining adequate volume as well as electrolyte and acid base balance Anticipating and preventing ... Nausea and vomiting 196 Fluids and Electrolytes Demystified • Abdominal cramps • Muscle twitching • Seizures and coma Treatment and nursing care center on managing fluid and electrolytes and preventing ... play a significant role in fluid, electrolyte, and acid base balance Since the renal system removes or retains fluids and electrolytes, as well as acids and bases, in the body, malfunction of this system...

Ngày tải lên: 11/08/2014, 17:21

... renal acid load and renal net acid excretion in healthy, free-living children and adolescents Am J Clin Nutr 2003, 77(5):1255-1260 13 Remer T, Manz F: Potential renal acid load of foods and its ... potential influence as a dietary influence on acid- base balance, the present study was undertaken to systematically evaluate changes in both hydration and acid- base balance following chronic consumption ... influences on markers for acid- base balance and hydration status when consumed under free-living conditions Since most studies evaluating nutritional influences on acid- base status are either large-scale...

Ngày tải lên: 11/08/2014, 23:21

... Function and Electrolytes; (III) Acute Kidney Injury and Chronic Renal Failure; (IV) Glomerular and Tubular Disorders; (V) Renal Vascular Disease; (VI) Urinary Tract Infections and Obstruction; and ... personal and professional views and not necessarily those of the U.S government TERMS OF USE This is a copyrighted work and McGraw-Hill Education, LLC and its licensors reserve all rights in and to ... practicing physicians to continuously update their knowledge base and clinical skills Our access to information through web-based journals and databases is remarkably efficient Although these sources...

Ngày tải lên: 22/10/2016, 13:38

... RLCH NƯỚC-ĐIỆN GIẢI CÂN BẰNG ACID- BASE HVQY MỤC TIÊU Đại cương CH nước-điện giải RLCH nước-điện giải Đại cượng CH cân acid- base RL cân acid- base I ĐẠI CƯ Ơ NG HVQY Phân bố nước thể...

Ngày tải lên: 03/12/2016, 00:42