FLUIDS, ELECTROLYTES, ACID – BASE BALANCE：液体，电解质，酸–酸碱平衡.ppt

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FLUIDS, ELECTROLYTES, ACID – BASE BALANCE：液体，电解质，酸–酸碱平衡.ppt

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FLUIDS, ELECTROLYTES, ACID – BASE BALANCE：液体，电解质，酸–酸碱平衡

Dextrose solutions are only hypertonic until dextrose is metabolized, then reflect underlying solution; often free water or hypotonic. Memory aid: tonic= salt hyper = high salt Nursing diagnoses need to reflect patient issues and Nursing domain NOT electrolyte values or blood gases Examples NRS 105 Collings 2011 * * FLUID OUTPUT REGULATION GI TRACT 3 – 6 LITERS OF ISOTONIC FLUID MOVES INTO THE GI TRACT AND THEN RETURNS TO THE EXTRACELLULAR FLUID SPACE Vomiting increases GI losses + electrolytes 200 ml OF FLUID IS LOST IN THE FECES EACH DAY DIARRHEA CAN INCREASE THIS LOSS NRS 105 Collings 2011 * * REGULATION OF ELECTROLYTES MAJOR CATIONS IN BODY FLUIDS SODIUM (Na+) POTASSIUM (K+) CALCIUM (Ca++) MAGNESIUM (Mg++) NRS 105 Collings 2011 * * REGULATION OF ELECTROLYTES SODIUM REGULATION MOST ABUNDANT CATION IN THE EXTRACELLULAR FLUID MAJOR CONTRIBUTOR TO MAINTAINING WATER BALANCE NERVE TRANSMISSION ** LOC, peripheral REGULATION OF ACID-BASE BALANCE CONTRIBUTES TO CELLULAR CHEMICAL REACTIONS SODIUM IS TAKEN IN VIA FOOD AND BALANCE IS MAINTAINED THROUGH ALDOSTERONE NRS 105 Collings 2011 * * REGULATION OF ELECTROLYTES POTASSIUM REGULATION MAJOR ELECTROLYTE AND PRINCIPLE CATION IN THE INTRACELLULAR FLUID REGULATES METABOLIC ACTIVITIES REQUIRED FOR GLYCOGEN DEPOSITS IN THE LIVER AND SKELETAL MUSCLE REQUIRED FOR TRANSMISSION OF NERVE IMPULSES, NORMAL CARDIAC CONDUCTION AND NORMAL SMOOTH AND SKELETAL MUSCLE CONTRACTION REGULATED BY DIETARY INTAKE AND RENAL EXCRETION NRS 105 Collings 2011 * * REGULATION OF ELECTROLYTES CALCIUM REGULATION STORED IN THE BONE, PLASMA AND BODY CELLS 99% OF CALCIUM IS IN THE BONES AND TEETH 1% IS IN EXTRACELLULAR FLUID 50% OF CALCIUM IN THE EXTRACELLULAR FLUID IS BOUND TO PROTEIN (ALBUMIN) 40% IS FREE IONIZED CALCIUM May be measured as Ionized or total Ca NRS 105 Collings 2011 * * REGULATION OF ELECTROLYTES CALCIUM REGULATION CALCIUM IS NECESSARY FOR BONE AND TEETH FORMATION BLOOD CLOTTING HORMONE SECRETION CELL MEMBRANE INTEGRITY CARDIAC CONDUCTIO