外科重点整理.docxVIP

引流管：fixation固定，unobstruction通畅，observation观察，无菌，记录oral care口腔护理，冲洗管腔remove移除Chapter2水电解质，酸碱平衡失调（田翀）1. DehydrationThree basic types :Isotonic dehydration等渗性缺水: water and dissolved electrolytes are lost in equal proportions; Hypertonic dehydration高渗性缺水: water loss is greater than electrolyte loss; Hypotonic dehydration低渗性缺水: electrolyte loss is greater than water loss.Hyponatremia: serum sodium （Na+） 135mmol/L. Hypernatremia: serum sodium 145mmol/L.Hypokalemia低钾血症: serum potassium 3.5mmol/L. Hyperkalemia高钾血症: serum potassium 5.5mmol/L.Hypocalcemia: total serum calcium （Ca2+） 2.25mmol/L. Hypercalcemia: total serum calcium 2.75mmol/L.Acidosis: arterial pH 7.35 Alkalosis: arterial pH 7.45ClassificationsCommon cause考选择题ACIDOSISMetabolic acidosisOverproduction of H+Excessive oxidation of fatty acids: diabetic ketoacidosis，starvationHypermetabolism: heavy exercise，fever，hypoxia，ischemiaExcessive ingestion of acids: ethanol intoxication，methanol ingestion，salicylate intoxication　Under-elimination of H+Renal failureUnder-productionor over-elimination of bicarbonateRenal failure，pancreatitis，liver failure，dehydration，diarrheaRespiratory acidosisCO2 accumulationRespiratory depression: anesthetics，poisons，electrolyte imbalance，trauma，neurologic diseasesInadequate chest expansion: skeletal deformities，nonpulmonary restriction （obesity，fluid，tumor，body casts）Airway obstruction: asthma，cancer，bronchiolitisAlveolar-capillary block: thrombus or embolus，vascular occlusive disease，pneumonia，pulmonary edema，tuberculosis，cystic fibrosis，atelectasis肺不张，acute respiratory distress syndrome （ARDS），emphysema，cancerMetabolic alkalosisIncrease of base componentsOral ingestion of bases: antacids，milk-alkali syndromeParenteral base administration: blood transfusion，sodium bicarbonate，total parenteral nutritionDecrease of acid componentsProlonged vomiting，nasogastric suctioning，Cushing’s syndrome，hyperaldosteronism，thiazide diureticsRespiratory alkalosisExcessive loss of carbon dioxideHyperve