fluid and electrolyte disturbance in human bodybhartisharma175
it explain about definition of fluid and electrolyte disturbance, causes and different types of fluid disturbance. diagnostic evaluation and their emergent management along with supportive management.
fluid and electrolyte disturbance in human bodybhartisharma175
it explain about definition of fluid and electrolyte disturbance, causes and different types of fluid disturbance. diagnostic evaluation and their emergent management along with supportive management.
Nsg care with Fluid & Electrolyte imbalance.pptxAbhishek Joshi
Helpful for first year GNM and B.Sc. Nurses students.
Keep Reading and i will keep uploading...i want to enhance the nursing profession and provide an ideal nursing care to one and every students of India. Thanks
Here, we discuss about the intake output chart.
The intake output chart is a vital in patient care. By maintaining intake output chart we can monitor the improvement of the patient. So, here we provide about the intake output chart, indications, procedure, precautions, maintaining chart and more.
Please read it attentively and upgrade your professional knowledge and apply it to practice.
Thanks
Nsg care with Fluid & Electrolyte imbalance.pptxAbhishek Joshi
Helpful for first year GNM and B.Sc. Nurses students.
Keep Reading and i will keep uploading...i want to enhance the nursing profession and provide an ideal nursing care to one and every students of India. Thanks
Here, we discuss about the intake output chart.
The intake output chart is a vital in patient care. By maintaining intake output chart we can monitor the improvement of the patient. So, here we provide about the intake output chart, indications, procedure, precautions, maintaining chart and more.
Please read it attentively and upgrade your professional knowledge and apply it to practice.
Thanks
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
5. Body fluids are
distributed in two
distinct area:
intracellular fluid
(ICF)
40% body weight
Extracellular fluid
(ECF)
20% body weight
Interstitial fluid -
15% body weight
Plasma -5% body
weight
12. Aldosterone
Hormone secreted from the
zona glomerulosa cells of
adrenal cortex
Stimulates kidneys
Retain sodium
Retain water
Secrete potassium
13. Antidiuretic hormone
Also called arginine vasopressin (AVP).
ADH is produced in neuron cell bodies
in supraoptic and paraventricular nuclei
of the Hypothalamus, and stored in
posterior pituitary.
Physiological function
Promote the reabsorption of water in
the collecting duct.
14. The natriuretic peptide family
Four peptides of this family have been identified, including:
Atrial natriuretic peptide (ANP)
Brain natriuretic peptide (BNP)
C-type natriuretic peptide (CNP)
Urodilatin
Function:
Diuretic and natriuretic actions
16. The sensation of thirst
Conscious desire for water
Major factor that determines fluid intake
Initiated by the osmoreceptors in
hypothalamus that are stimulated by
increase in osmotic pressure of body fluids
Also stimulated by a decrease in the blood
pressure through the baroreceptors.
17. The regulation of thirsty reaction
The stimulus sensed by osmoreceptor:
• Not a change in the extracellular fluid osmolality
• But a change in osmoreceptor neuron size or in the some intracellular substance.
18.
19.
20.
21. Abnormalities in the Regulation of Body Fluid.
Fluid Volume Deficit (ECFVD)- Dehydration
Fluid Volume Excess- Over hydration
22. Extra Cellular Fluid Volume
Deficit (ECFVD)
A decrease in intravascular and interstitial fluids.
It is a common and serious fluid imbalance that results
in vascular fluid volume loss (hypovolemia).
24. Degrees of dehydration:
o Mild
o Moderate
o Severe
Types of dehydration:
o Hyper-osmolar
o Iso-osmolar
o Hypo-osmolar
25.
26. Laboratory findings:
Increased Osmolality
Increased or normal serum sodium level
BUN (> 25 mg/d1)
Hyperglycaemia (>120 mg / dl)
Increased specific gravity of urine
Elevated hematocrit (>55%)
27. Management of Dehydration
Oral rehydration
IV fluids
Correction of the underlying problem
Dietary management
Nursing management
28.
29. Falls Precautions:
Assess for orthostatic hypotension
Assess muscle strength in legs
Orient the client to the environment
Remind the client to call for help before getting out of bed or
a chair
Help the client get out of bed or a chair
Provide, or remind the client to use, a walker or cane for
ambulating
30. Provide adequate lighting at all times, especially at night
Keep the call light within reach, and ensure that the client can
use it
Place the bed in the lowest position with the brakes locked
Place objects that the client needs within reach
Ensure that adequate handrails are present in the client's room,
bathroom, and hall
Encourage family members or significant other to stay with the
client
31. Extra Cellular Fluid Volume Excess/
Overhydration
ECFVE is increased fluid retention in the intravascular
& interstitial spaces (third spacing)
32. Etiology:
Administering fluids rapidly or in a large amount
Failure to excrete fluids:
o Heart failure
o Renal disorders
o Venous obstructions
o Decreased plasma proteins
o Excessive fluid ingestion
o Increased ADH & Aldosterone
Decreased Excretion
Increased absorption
33.
34.
35. Laboratory findings:
Decreased Osmolality
Decreased or normal serum sodium level
BUN (<8 mg/dl)
Decreased specific gravity of urine
Decreased hematocrit (<45%)
36. Management of over hydration
ICFVE is treated by the addition of solutes to IV fluids.
Use of D5%, 0.45% Nacl will help to correct ICFVE
when the cause is water excess.
Oral fluids such as water and soft drinks should be
given in addition to water and ice chips.
IV therapy should be monitored every hour.
37. Monitor vital signs and intake- output
Weight should be checked daily to measure fluid gain or
loss.
Administer prescribed antiemetic as needed to allow
food and fluids to be ingested.
Safety measures are necessary when the client displays
behavioral changes.
38. NURSING INTERVENTIONS
Monitor cardiovascular, respiratory, neuromuscular,
renal, integumentary, and gastrointestinal status.
Prevent further fluid overload and restore normal fluid
balance.
Administer diuretics; osmotic diuretics typically are
prescribed first to prevent severe electrolyte imbalances.
39. Restrict fluid and sodium intake as prescribed.
Monitor intake and output; monitor weight.
Monitor electrolyte values, and prepare to administer
medication to treat an imbalance if present.
42. Hyponatremia
• Definition:
– Commonly defined as a serum sodium
concentration <135 mEq/L
– Hyponatremia represents a relative excess of
water in relation to sodium.
43. Hyponatremia is the most common electrolyte disorder
Acute hyponatremia (developing over 48hr or less) are
subject to more severe degrees of cerebral edema
sodium level is less than 105 mEq/L, the mortality is
over 50%
Chronic hyponatremia (developing over more than 48hr)
experience milder degrees of cerebral edema
45. Hypovolemic hyponatremia
Develops as sodium and free water are lost and/or
replaced by inappropriately hypotonic fluids
Sodium can be lost through renal or non-renal routes
46. Nonrenal loss:
GI losses
Vomiting, Diarrhea, fistulas, pancreatitis
Excessive sweating
Third spacing of fluids
ascites, peritonitis, pancreatitis, and burns
Cerebral salt-wasting syndrome
traumatic brain injury, aneurysmal subarachnoid
hemorrhage, and intracranial surgery
Must distinguish from SIADH
48. Euvolemic hyponatremia
Sodium deficit is more and the volume remains same.
Etiology:
Psychogenic polydipsia, often in psychiatric patients
Administration of hypotonic intravenous (5% DW) or
irrigation fluids ( sorbitol, glycerin) in the immediate
postoperative period
49. administration of hypotonic maintenance intravenous
fluids
Infants who may have been given inappropriate
amounts of free water
bowel preparation before colonoscopy or colorectal
surgery
50. Hypervolemic hyponatremia
Total body sodium increases, and TBW increases to a greater
extent.
Can be renal or non-renal
acute or chronic renal failure
dysfunctional kidneys are unable to excrete the ingested
sodium load
cirrhosis, congestive heart failure, or nephrotic syndrome
51. Redistributive hyponatremia
Water shifts from the intracellular to the extracellular
compartment, with a resultant dilution of sodium. The TBW
and total body sodium are unchanged.
This condition occurs with hyperglycemia
Administration of mannitol
52. MEDICAL MANAGEMENT
Determine cause of hyponatremia and to correct it.
If client has hyponatremia due to fluid volume excess,
intake of fluids will be restricted to allow the sodium to
regain balance.
If the serum sodium level falls below 125 mEq/L,
sodium replacement is needed.
53. PHARMACOLOGIC MANAGEMENT
For client with moderate hyponatremia 125 meq/ L I/V
saline solution (0.9% Nacl) or lactated Ringer solution
may be ordered.
When the serum sodium level is 115 meq / L or less, a
concentrated saline solution such as 3 % Nacl is
indicated.
54. NURSING INTERVENTIONS
Monitor cardiovascular, respiratory, neuromuscular,
cerebral, renal, and gastrointestinal status of the client.
If hyponatremia is accompanied by a fluid volume
deficit (hypovolemia), IV sodium chloride infusions are
administered to restore sodium content and fluid
volume.
55. If hyponatremia is accompanied by fluid volume
excess (hypervolemia), osmotic diuretics are
administered to promote the excretion of water rather
than sodium.
Instruct the client to increase oral sodium intake and
inform the client about the foods to include in the diet.
If the client is taking lithium (Lithobid), monitor the
lithium level, because hyponatremia can cause
diminished lithium excretion, resulting in toxicity.
56. Hypernatremia
Hypernatremia is usually due to water deficit
Etiology:
Excess water loss : eg- heat exposure
diabetes insipidus
Impaired thirst: eg - primary hypodypsia,
comatose
Excessive Na+ retention
57. Clinical features of hypernatremia
Excessive thirst, polyuria, nausea
Muscular weakness, neuromuscular
irritability
Altered mental status,focal
neurological deficit occasionally coma
or seizures
58. Treatment
correct water deficit
Rate of correction :
-Acute hypernatremia- 1mEq/L/hr
-Chronic hypernatremia-1mEq/L/hr or 10mEq/L over 24hr
-rapid correction may lead to cerebral edema
66. Pharmacological Management
Oral potassium replacement therapy is usually prescribed for
mild hypokalemia.
Potassium is extremely irritating to gastric mucosa; therefore
the drug must be taken with Glass of water or juice or during
meals.
Potassium chloride can be administered intravenously for
moderate or severe hypokalemia & must be diluted in IV
fluids.
67. Administration of potassium by IV push may result in
cardiac arrests. Potassium can be given in doses of 10 to
20 mEq/ hour diluted in IV fluid if the client is on heart
monitor.
High concentration of potassium is irritating to heart
muscle. Thus correcting a potassium deficit may take
several days.
68. Dietary management
The administration of foods
that are high in potassium
help to correct the problem
as well as prevent further
potassium losses.
74. MEDICAL MANAGEMENT
When serum potassium level is 5.0 to 5.5 mEq/L restrict
potassium intake.
If potassium Excess is due to metabolic acidosis,
correcting the acidosis with sodium bicarbonate
promotes potassium uptake into the cells.
Improving urine output decreases elevated serum
potassium level.
75. DIETARY MANAGEMENT
When hyperkalemia is severe, immediate actions are
needed to be taken to avoid severe Cardiac disturbances.
The administration of foods that are low in potassium help
to correct the problem as well as prevent further
potassium excess.
76.
77. NURSING INTERVENTIONS
Monitor cardiovascular, respiratory, neuromuscular,
renal, and gastrointestinal status; place the client on a
cardiac monitor.
Discontinue IV potassium and hold oral potassium
supplements.
Prepare to administer potassium-excreting diuretics if
renal function is not impaired.
78. Initiate a potassium-restricted diet.
If renal function is impaired, prepare to administer
sodium polystyrene sulfonate (Kayexalate).
Prepare the client for dialysis if potassium levels are
critically high.
Prepare for the IV administration of hypertonic glucose
with regular insulin to move excess potassium into the
cells.
79. Monitor renal function.
Teach the client to avoid foods high in potassium.
Instruct the client to avoid the use of salt substitutes or
other potassium-containing substances.
89. MEDICAL MANAGEMENT
Determining & correcting the cause of hypocalcemia.
Asymptomatic hypocalcemia is usually corrected with oral
calcium gluconate, calcium lactate or calcium chloride.
Administer calcium supplements 30 minutes before meals
for better absorption and with glass of milk because vitamin
D is necessary for absorption of calcium from the intestine.
90. Intravenous calcium chloride or calcium gluconate
(10%) is given slowly to avoid hypertension,
bradycardia & other arrhythmias.
Chronic or mild hypocalcemia can be treated in part by
having the client consume a diet high in calcium.
91.
92. NURSING INTERVENTIONS
Monitor cardiovascular, respiratory, neuromuscular, and
gastrointestinal status; place the client on a cardiac monitor.
Administer calcium supplements orally or calcium
intravenously.
When administering calcium intravenously, warm the injection
solution to body temperature before administration and
administer slowly, monitor for electrocardiographic changes,
and monitor for hypercalcemia.
93. Administer medications that increase calcium
absorption. i.e. Vitamin D aids in the absorption of
calcium from the intestinal tract.
Initiate seizure precautions.
Keep 10% calcium gluconate available for treatment of
acute calcium deficit.
Instruct the client to consume foods high in calcium.
98. MEDICAL MANAGEMENT
Treatment consists of correcting the underlying cause.
Intravenous normal saline (0.9% Nacl) given rapidly
with furosemide to prevent fluid overload, Promote
urinary calcium excretion.
Corticosteroid drugs decrease calcium levels by
competing with vitamin D thus resulting in decreased
intestinal absorption of calcium.
99. If the cause is excessive use of calcium or vitamin D
supplements or calcium containing antacids these agents
should be either avoided or used in reduced dosage.
A newer form of drug therapy is etidronate di-sodium.
This drug reduces serum calcium by reducing normal
and abnormal bone reabsorption of calcium and
secondarily by reducing bone formation.
100. NURSING INTERVENTIONS
Monitor cardiovascular, respiratory, neuromuscular, renal,
and gastrointestinal status; place the client on a cardiac
monitor.
Discontinue IV infusions of solutions containing calcium and
oral medications containing calcium or vitamin D.
Discontinue thiazide diuretics and replace with diuretics that
enhance the excretion of calcium.
101. Administer medications as prescribed that inhibit calcium
resorption from the bone, such as phosphorus, calcitonin,
bisphosphonates, and prostaglandin synthesis inhibitors
(aspirin, nonsteroidal anti-inflammatory drugs).
Prepare the client with severe hypercalcemia for dialysis if
medications fail to reduce the serum calcium level.
Instruct the client to avoid foods high in calcium.
108. Causes of hyperphosphatemia
Excess intake of high phosphate foods
Excess vitamine D supplementation especially in renal
insufficiency
Impaired colonic motility
Hypoparathyroidism
Addison’s disease
110. Management:
Mild cases- limit phosphate rich foods ( milk, ice-cream,
cheese, meat, fish)
Giving calcium, aluminium products that promotes
binding & excretion of phosphate.
Dialysis is the TOC in case of hyperphosphatemia with
renal failure.
118. Causes of hypermagnesemia
Renal insufficiency
Excessive anta-acid use
Adrenal insufficiency
Ketoacidosis
119. Clinical manifestations
Clinical amnifestations are related to blocked release of
Acetylcholine from myoneronal junction which affects muscle
cell activity.
Hypotension
Muscle weakness
Loss of DTR
Prolonged QT, PR interval
Lethargy, drowiness
Respiratory paralysis, loss of consiosness
120. Management:
Low magnesium diet (eat chicken, eggs, green peas, white
bread, hamburger)
Decrease magnesium sulphate use
In severe cases saline infusion with diuretics is give to
promote magnesium excretion
IV calcium (antagonistic action)
Drugs: Albuterol
If renal failure is also present than hemodialysis is done in
severe cases
121.
122.
123.
124. Bibliography
Priscilla Lemone, Karen Burke. “Medical surgical nursing, critical thinking in client care”.
4th edition (2008). Page no. 185-198
Ignatavicius Workman. “Medical surgical nursing, Patient centred collaborative care”. 6th
edition (2010). Elsevier publication. Page no. 1022-1024
Brunner and Suddharth. “Text book of medical surgical nursing”. Page no. 249-255
Guyyton and Hall. “Text book of medical physiology”. 11th edition (2006). Elsevier
publications. Page no. 642-650
Gerard.J.Tortora. “Principles of anatomy and physiology”. 11th edition (2006). Wiley
publication. Page no. 1122-1130
125. K. Sembulingam, Prema Sembulingam. “Essentials of medical
physiology”. 5thedition (2010). Jaypee publications. Page no. 302-
309
126.
127.
128.
129.
130.
131.
132. 1. The type of fluid used to manipulate fluid shifts
among compartments states is:
A. Whole blood
B. TPN
C. Albumin
D. Normal saline
133. 2. The balance of anions and cations as it occurs
across cell membranes is known as:
A. osmotic activity
B. Electrical neutrality
C. Electrical stability
D. Sodium potassium pump
134. 3. A diet containing the minimum
daily sodium requirement for an adult would
be:
A. no-salt diet
B. diet including 2 gm sodium
C. diet including 4 gm sodium
D. 1500 calorie weight-loss diet