This document discusses fluid balance and fluid compartments in the human body. It defines key terms like total body water, extracellular fluid, intracellular fluid, osmolality, tonicity, electrolytes and explains the distribution and regulation of body water. It also describes hypovolemia, its causes, diagnostic criteria and management approaches for hemorrhagic and non-hemorrhagic hypovolemia. Common intravenous fluids are classified and their properties and uses are explained.
This document discusses fluid and electrolyte physiology and fluid therapy. It covers fluid distribution in the body, osmolality, tonicity, fluid requirements in children, and types of fluids. It then discusses fluid assessment including resuscitation, maintenance, redistribution and replacement. Specific guidance is provided on fluid resuscitation in conditions like sepsis and severe acute malnutrition. Complications of fluid therapy like electrolyte imbalances are also summarized.
The document discusses fluid and electrolyte balance in the human body, noting that fluid intake and losses must balance and disturbances can impact various organ systems. Total body water and the volumes of intravascular and extravascular fluid are explained. Different types of fluid imbalances like volume depletion, volume overload, and electrolyte disturbances are also outlined.
Body fluids make up around 60% of total body weight and consist of water and dissolved electrolytes and non-electrolytes. They are divided into intracellular fluid, which forms around 2/3 of total body water, and extracellular fluid, which includes plasma, interstitial fluid, and transcellular fluid. The composition of these fluid compartments differs, with intracellular fluid containing higher potassium concentrations and extracellular fluid containing higher sodium concentrations. Abnormalities in electrolyte concentrations can impact fluid balance and cell function. Isotonic, hypotonic, and hypertonic solutions are defined based on their osmolarity compared to cell membranes, and this determines the movement of water across membranes. Intravenous fluids are administered in isotonic
This document discusses perioperative fluid therapy. It begins by defining fluid compartments and compositions. It then discusses fluid balance and exchange between compartments via diffusion, osmosis, and hydrostatic/oncotic pressures. Specific conditions like hyponatremia and hypernatremia are examined along with calculating fluid deficits and replacements. Intravenous fluid types and their properties are outlined as well as estimating fluid requirements. Surgical fluid losses and allowable blood loss calculations are provided. Patient positioning and essential anesthesia monitors are also mentioned.
electrolytes mbbs class 2024 new.pptx pptdinesh kumar
This document discusses electrolyte disturbances and provides details about electrolyte composition in the body, osmolarity and osmolality of body fluids, regulation of electrolytes, and conditions involving electrolyte imbalances like dehydration, overhydration, and water intoxication. It focuses on sodium as a key electrolyte, outlining its functions, dietary requirements, and sources. The key points are that sodium and other electrolytes are essential for fluid balance, cell function, and acid-base regulation, and imbalances can result in serious health issues.
This document discusses fluid and electrolyte balance and management. It covers the composition of body fluids, mechanisms that regulate fluid homeostasis, and types of parenteral fluid therapy including crystalloids like saline solutions and dextrose solutions, as well as colloid solutions. It provides guidelines on fluid replacement and maintenance requirements, and examples of intravenous fluid orders.
This document discusses fluid balance and fluid compartments in the human body. It defines key terms like total body water, extracellular fluid, intracellular fluid, osmolality, tonicity, electrolytes and explains the distribution and regulation of body water. It also describes hypovolemia, its causes, diagnostic criteria and management approaches for hemorrhagic and non-hemorrhagic hypovolemia. Common intravenous fluids are classified and their properties and uses are explained.
This document discusses fluid and electrolyte physiology and fluid therapy. It covers fluid distribution in the body, osmolality, tonicity, fluid requirements in children, and types of fluids. It then discusses fluid assessment including resuscitation, maintenance, redistribution and replacement. Specific guidance is provided on fluid resuscitation in conditions like sepsis and severe acute malnutrition. Complications of fluid therapy like electrolyte imbalances are also summarized.
The document discusses fluid and electrolyte balance in the human body, noting that fluid intake and losses must balance and disturbances can impact various organ systems. Total body water and the volumes of intravascular and extravascular fluid are explained. Different types of fluid imbalances like volume depletion, volume overload, and electrolyte disturbances are also outlined.
Body fluids make up around 60% of total body weight and consist of water and dissolved electrolytes and non-electrolytes. They are divided into intracellular fluid, which forms around 2/3 of total body water, and extracellular fluid, which includes plasma, interstitial fluid, and transcellular fluid. The composition of these fluid compartments differs, with intracellular fluid containing higher potassium concentrations and extracellular fluid containing higher sodium concentrations. Abnormalities in electrolyte concentrations can impact fluid balance and cell function. Isotonic, hypotonic, and hypertonic solutions are defined based on their osmolarity compared to cell membranes, and this determines the movement of water across membranes. Intravenous fluids are administered in isotonic
This document discusses perioperative fluid therapy. It begins by defining fluid compartments and compositions. It then discusses fluid balance and exchange between compartments via diffusion, osmosis, and hydrostatic/oncotic pressures. Specific conditions like hyponatremia and hypernatremia are examined along with calculating fluid deficits and replacements. Intravenous fluid types and their properties are outlined as well as estimating fluid requirements. Surgical fluid losses and allowable blood loss calculations are provided. Patient positioning and essential anesthesia monitors are also mentioned.
electrolytes mbbs class 2024 new.pptx pptdinesh kumar
This document discusses electrolyte disturbances and provides details about electrolyte composition in the body, osmolarity and osmolality of body fluids, regulation of electrolytes, and conditions involving electrolyte imbalances like dehydration, overhydration, and water intoxication. It focuses on sodium as a key electrolyte, outlining its functions, dietary requirements, and sources. The key points are that sodium and other electrolytes are essential for fluid balance, cell function, and acid-base regulation, and imbalances can result in serious health issues.
This document discusses fluid and electrolyte balance and management. It covers the composition of body fluids, mechanisms that regulate fluid homeostasis, and types of parenteral fluid therapy including crystalloids like saline solutions and dextrose solutions, as well as colloid solutions. It provides guidelines on fluid replacement and maintenance requirements, and examples of intravenous fluid orders.
Fluid Therapy is the administration of fluids to a patient as a treatment or preventative measure. It can be administered via an intravenous, intraperitoneal, intraosseous, subcutaneous and oral routes. 60% of total bodyweight is accounted for by the total body water.
Different fluids can be
cyrstalloids, colloids, hypertonic saline, hypotonic saline, ringer lactate.
The document discusses disorders of water and electrolyte metabolism. It covers homeostasis of water and electrolytes, common electrolyte imbalances seen in disease, and key mechanisms that regulate fluid and electrolyte balance in the body, including thirst, antidiuretic hormone, aldosterone, and osmoreceptors.
The document discusses principles of acid-base balance in veterinary practice. It covers topics like water balance, electrolytes, acid-base balance, renal functions, fluid compartments, fluid therapy, dehydration assessment and treatment, electrolyte imbalances, and commercially available fluids. Key points include the importance of water and electrolytes for life, roles of kidneys and blood in acid-base balance maintenance, classification and assessment of dehydration severity, and fluid therapy considerations like cause, degree of dehydration, and patient condition.
This document provides information about body fluids and blood. It discusses topics like total body water and its relationship to age, sex, and fat. It describes the different body fluid compartments, their osmotic compositions, and the principles of water movement between compartments. It also covers the general properties and functions of blood, erythropoiesis, leucopoiesis, blood groups, and hemostasis.
The document discusses fluid and electrolyte balance in the human body. It begins by explaining that approximately 60% of the average adult's weight consists of fluid located in two compartments - intracellular fluid and extracellular fluid. It then defines key concepts like osmosis, diffusion, filtration, and the sodium-potassium pump which help regulate fluid levels. The document closes by reviewing the major routes of fluid gain and loss in the body, primarily through drinking, eating, urine output, and sweating.
Iv fluid therapy (types, indications, doses calculation)kholeif
Intravenous fluid therapy is essential for maintaining normal body functioning and hydration. There are three main types of intravenous fluids - colloids, crystalloids, and blood products. Crystalloids include isotonic fluids like 0.9% sodium chloride and lactated Ringer's solution, hypotonic fluids, and hypertonic fluids. Isotonic fluids maintain intravascular volume while hypotonic and hypertonic fluids shift fluid between intravascular and intracellular spaces. Close monitoring is needed with intravenous fluid therapy to avoid complications of overhydration or dehydration.
The document discusses disorders of water and electrolyte metabolism. It covers:
- Water and electrolytes (ions like sodium, potassium, calcium) are important components of body fluids that help regulate cell function and metabolism.
- Homeostasis (balance) of water volume, electrolyte levels, and fluid distribution between intracellular and extracellular compartments is vital. Disorders can result from diseases that cause vomiting, diarrhea, or other fluid/electrolyte imbalances.
- Understanding the pathogenesis (cause) and changes in water and electrolyte disturbances is important for clinical work in treating disorders. Factors like antidiuretic hormone and aldosterone help regulate fluid balance and electrolyte levels in the body
The document discusses fluid, electrolyte, and acid-base disturbances. It covers fluid compartments and regulation, electrolyte composition and balance, acid-base balance mechanisms, causes and assessment of dehydration, and management of dehydration through oral rehydration and intravenous fluids. Common electrolyte imbalances like hyponatremia and causes of hyponatremia are also mentioned.
WATER AND ELECTROLYTE BALANCE in normal and abnorm'ivvalashaker1
This document discusses fluid and electrolyte balance and imbalance. It outlines the body's water compartments and electrolyte composition of body fluids. Key concepts covered include osmolality, tonicity, and the mechanisms that regulate sodium and water balance such as the renin-angiotensin system and antidiuretic hormone. Causes, features, and treatment of various fluid and electrolyte imbalances like dehydration, overhydration, and derangements in sodium balance are described. Learning objectives related to fluid, electrolyte, and acid-base physiology are also listed.
fluid and electrolytes and acidosis and alkalosisAashish Parihar
This document provides an overview of fluid, electrolyte and acid-base balance. It discusses the distribution and composition of body fluids, the movement and regulation of fluids and electrolytes, types of acid-base imbalances, types of intravenous fluids, measuring fluid intake and output, and maintaining intake-output charts. It also covers initiating IV therapy, regulating IV flow rates, intravenous system maintenance, changing IV dressings, blood transfusions, and conditions requiring fluid restriction.
Crystalloids are electrolyte solutions that can freely diffuse throughout the extracellular space. The principal crystalloid is isotonic saline (0.9% NaCl), which expands the interstitial space rather than plasma volume. Ringer's lactate is also commonly used as it more closely matches plasma composition. Dextrose 5% in water (D5W) is hypotonic and expands both intra and extracellular spaces, providing calories but not electrolytes. Each crystalloid has different indications and disadvantages to consider when selecting the appropriate fluid for treatment.
This document discusses fluids and electrolytes. It covers total body fluid compartments, including intracellular fluid, extracellular fluid, intravascular fluid, and interstitial fluid. It describes fluid requirements and regulation, causes of hypovolemia, signs and symptoms, treatment with crystalloids and colloids. It also addresses osmolarity, factors that affect fluid distribution between compartments, and third-spacing of fluids.
Basic Intravenous Therapy 3: Fluids And Electrolytes, Balance and Imbalance, ...Ronald Magbitang
Lecture Presentation in Basic Intravenous Therapy Seminar, discussion on Body Fluids and Electrolytes, Normal Values and the Imbalances, the symptomatology and treatment and precautions, and, finally the different types of commonly available, utilized IVF in clinics
Sodium metabolism and its clinical applicationsrohini sane
A comprehensive presentation on Sodium Metabolism and its clinical significance for MBBS, BDS, B Pharm & Biotechnology students to facilitate self- study.
This document discusses intravenous fluid therapy and different types of intravenous fluids. It begins by explaining the importance of fluid balance in the body and defining key terms like intracellular fluid, extracellular fluid, and total body water. It then describes various fluid types including isotonic fluids like 0.9% sodium chloride and lactated Ringer's solution, hypotonic fluids, hypertonic fluids, and colloid fluids. For each type of fluid, it provides examples, indications for use, and important precautions.
This document discusses intravenous fluids and oral rehydration solutions. It begins by outlining the learning objectives, which are to describe different types of IV fluids, their indications and complications, and the constituents of ORS. It then discusses the distribution of fluid in the body and different classifications of IV fluids including crystalloids versus colloids, isotonic versus hypotonic versus hypertonic solutions, and natural versus synthetic fluids. Specific fluids are described like normal saline, Ringer's lactate, dextrose, albumin, gelatins and dextrans. The document concludes by covering oral rehydration in diarrhea and the WHO ORS formula.
The document discusses fluid and electrolyte balance in the human body. It covers key topics like the components of body fluids, fluid compartments, electrolytes, fluid movement through diffusion, osmosis and active transport, causes of fluid shifts, effects of fluid imbalances, edema, and fluid resuscitation approaches.
The document discusses fluid, electrolyte, and acid-base balance in the human body. It describes:
1) The distribution of body fluids between intracellular fluid (ICF) and extracellular fluid (ECF), and the composition of each, including principal electrolytes.
2) Mechanisms of fluid movement such as diffusion, filtration, active transport, and osmosis.
3) Causes and types of fluid and electrolyte imbalances like dehydration, edema, and acid-base disturbances.
4) Systems that regulate acid-base balance including buffers, respiration, and the kidneys.
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
Fluid Therapy is the administration of fluids to a patient as a treatment or preventative measure. It can be administered via an intravenous, intraperitoneal, intraosseous, subcutaneous and oral routes. 60% of total bodyweight is accounted for by the total body water.
Different fluids can be
cyrstalloids, colloids, hypertonic saline, hypotonic saline, ringer lactate.
The document discusses disorders of water and electrolyte metabolism. It covers homeostasis of water and electrolytes, common electrolyte imbalances seen in disease, and key mechanisms that regulate fluid and electrolyte balance in the body, including thirst, antidiuretic hormone, aldosterone, and osmoreceptors.
The document discusses principles of acid-base balance in veterinary practice. It covers topics like water balance, electrolytes, acid-base balance, renal functions, fluid compartments, fluid therapy, dehydration assessment and treatment, electrolyte imbalances, and commercially available fluids. Key points include the importance of water and electrolytes for life, roles of kidneys and blood in acid-base balance maintenance, classification and assessment of dehydration severity, and fluid therapy considerations like cause, degree of dehydration, and patient condition.
This document provides information about body fluids and blood. It discusses topics like total body water and its relationship to age, sex, and fat. It describes the different body fluid compartments, their osmotic compositions, and the principles of water movement between compartments. It also covers the general properties and functions of blood, erythropoiesis, leucopoiesis, blood groups, and hemostasis.
The document discusses fluid and electrolyte balance in the human body. It begins by explaining that approximately 60% of the average adult's weight consists of fluid located in two compartments - intracellular fluid and extracellular fluid. It then defines key concepts like osmosis, diffusion, filtration, and the sodium-potassium pump which help regulate fluid levels. The document closes by reviewing the major routes of fluid gain and loss in the body, primarily through drinking, eating, urine output, and sweating.
Iv fluid therapy (types, indications, doses calculation)kholeif
Intravenous fluid therapy is essential for maintaining normal body functioning and hydration. There are three main types of intravenous fluids - colloids, crystalloids, and blood products. Crystalloids include isotonic fluids like 0.9% sodium chloride and lactated Ringer's solution, hypotonic fluids, and hypertonic fluids. Isotonic fluids maintain intravascular volume while hypotonic and hypertonic fluids shift fluid between intravascular and intracellular spaces. Close monitoring is needed with intravenous fluid therapy to avoid complications of overhydration or dehydration.
The document discusses disorders of water and electrolyte metabolism. It covers:
- Water and electrolytes (ions like sodium, potassium, calcium) are important components of body fluids that help regulate cell function and metabolism.
- Homeostasis (balance) of water volume, electrolyte levels, and fluid distribution between intracellular and extracellular compartments is vital. Disorders can result from diseases that cause vomiting, diarrhea, or other fluid/electrolyte imbalances.
- Understanding the pathogenesis (cause) and changes in water and electrolyte disturbances is important for clinical work in treating disorders. Factors like antidiuretic hormone and aldosterone help regulate fluid balance and electrolyte levels in the body
The document discusses fluid, electrolyte, and acid-base disturbances. It covers fluid compartments and regulation, electrolyte composition and balance, acid-base balance mechanisms, causes and assessment of dehydration, and management of dehydration through oral rehydration and intravenous fluids. Common electrolyte imbalances like hyponatremia and causes of hyponatremia are also mentioned.
WATER AND ELECTROLYTE BALANCE in normal and abnorm'ivvalashaker1
This document discusses fluid and electrolyte balance and imbalance. It outlines the body's water compartments and electrolyte composition of body fluids. Key concepts covered include osmolality, tonicity, and the mechanisms that regulate sodium and water balance such as the renin-angiotensin system and antidiuretic hormone. Causes, features, and treatment of various fluid and electrolyte imbalances like dehydration, overhydration, and derangements in sodium balance are described. Learning objectives related to fluid, electrolyte, and acid-base physiology are also listed.
fluid and electrolytes and acidosis and alkalosisAashish Parihar
This document provides an overview of fluid, electrolyte and acid-base balance. It discusses the distribution and composition of body fluids, the movement and regulation of fluids and electrolytes, types of acid-base imbalances, types of intravenous fluids, measuring fluid intake and output, and maintaining intake-output charts. It also covers initiating IV therapy, regulating IV flow rates, intravenous system maintenance, changing IV dressings, blood transfusions, and conditions requiring fluid restriction.
Crystalloids are electrolyte solutions that can freely diffuse throughout the extracellular space. The principal crystalloid is isotonic saline (0.9% NaCl), which expands the interstitial space rather than plasma volume. Ringer's lactate is also commonly used as it more closely matches plasma composition. Dextrose 5% in water (D5W) is hypotonic and expands both intra and extracellular spaces, providing calories but not electrolytes. Each crystalloid has different indications and disadvantages to consider when selecting the appropriate fluid for treatment.
This document discusses fluids and electrolytes. It covers total body fluid compartments, including intracellular fluid, extracellular fluid, intravascular fluid, and interstitial fluid. It describes fluid requirements and regulation, causes of hypovolemia, signs and symptoms, treatment with crystalloids and colloids. It also addresses osmolarity, factors that affect fluid distribution between compartments, and third-spacing of fluids.
Basic Intravenous Therapy 3: Fluids And Electrolytes, Balance and Imbalance, ...Ronald Magbitang
Lecture Presentation in Basic Intravenous Therapy Seminar, discussion on Body Fluids and Electrolytes, Normal Values and the Imbalances, the symptomatology and treatment and precautions, and, finally the different types of commonly available, utilized IVF in clinics
Sodium metabolism and its clinical applicationsrohini sane
A comprehensive presentation on Sodium Metabolism and its clinical significance for MBBS, BDS, B Pharm & Biotechnology students to facilitate self- study.
This document discusses intravenous fluid therapy and different types of intravenous fluids. It begins by explaining the importance of fluid balance in the body and defining key terms like intracellular fluid, extracellular fluid, and total body water. It then describes various fluid types including isotonic fluids like 0.9% sodium chloride and lactated Ringer's solution, hypotonic fluids, hypertonic fluids, and colloid fluids. For each type of fluid, it provides examples, indications for use, and important precautions.
This document discusses intravenous fluids and oral rehydration solutions. It begins by outlining the learning objectives, which are to describe different types of IV fluids, their indications and complications, and the constituents of ORS. It then discusses the distribution of fluid in the body and different classifications of IV fluids including crystalloids versus colloids, isotonic versus hypotonic versus hypertonic solutions, and natural versus synthetic fluids. Specific fluids are described like normal saline, Ringer's lactate, dextrose, albumin, gelatins and dextrans. The document concludes by covering oral rehydration in diarrhea and the WHO ORS formula.
The document discusses fluid and electrolyte balance in the human body. It covers key topics like the components of body fluids, fluid compartments, electrolytes, fluid movement through diffusion, osmosis and active transport, causes of fluid shifts, effects of fluid imbalances, edema, and fluid resuscitation approaches.
The document discusses fluid, electrolyte, and acid-base balance in the human body. It describes:
1) The distribution of body fluids between intracellular fluid (ICF) and extracellular fluid (ECF), and the composition of each, including principal electrolytes.
2) Mechanisms of fluid movement such as diffusion, filtration, active transport, and osmosis.
3) Causes and types of fluid and electrolyte imbalances like dehydration, edema, and acid-base disturbances.
4) Systems that regulate acid-base balance including buffers, respiration, and the kidneys.
Similar to L10-IV Fluids.ppt NURSING MANARGEMENT IV (20)
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
Can coffee help me lose weight? Yes, 25,422 users in the USA use it for that ...nirahealhty
The South Beach Coffee Java Diet is a variation of the popular South Beach Diet, which was developed by cardiologist Dr. Arthur Agatston. The original South Beach Diet focuses on consuming lean proteins, healthy fats, and low-glycemic index carbohydrates. The South Beach Coffee Java Diet adds the element of coffee, specifically caffeine, to enhance weight loss and improve energy levels.
Let's Talk About It: Breast Cancer (What is Mindset and Does it Really Matter?)bkling
Your mindset is the way you make sense of the world around you. This lens influences the way you think, the way you feel, and how you might behave in certain situations. Let's talk about mindset myths that can get us into trouble and ways to cultivate a mindset to support your cancer survivorship in authentic ways. Let’s Talk About It!
At Apollo Hospital, Lucknow, U.P., we provide specialized care for children experiencing dehydration and other symptoms. We also offer NICU & PICU Ambulance Facility Services. Consult our expert today for the best pediatric emergency care.
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Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
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About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
2024 HIPAA Compliance Training Guide to the Compliance OfficersConference Panel
Join us for a comprehensive 90-minute lesson designed specifically for Compliance Officers and Practice/Business Managers. This 2024 HIPAA Training session will guide you through the critical steps needed to ensure your practice is fully prepared for upcoming audits. Key updates and significant changes under the Omnibus Rule will be covered, along with the latest applicable updates for 2024.
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Hypertension and it's role of physiotherapy in it.Vishal kr Thakur
This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is summary of hypertension -
Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
Comprehensive Rainy Season Advisory: Safety and Preparedness Tips.pdfDr Rachana Gujar
The "Comprehensive Rainy Season Advisory: Safety and Preparedness Tips" offers essential guidance for navigating rainy weather conditions. It covers strategies for staying safe during storms, flood prevention measures, and advice on preparing for inclement weather. This advisory aims to ensure individuals are equipped with the knowledge and resources to handle the challenges of the rainy season effectively, emphasizing safety, preparedness, and resilience.
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardso...rightmanforbloodline
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
12. General information
Total body water is 60% of body weight
Influenced by age,sex and lean body
mass
Older age and female sex is less precent
To calculate TBW needed:
Male sex TBW= BW× 0.6
Female sex TBW= BW × 0.5
13. Body fluid compartments:
Intracellular volume
(40%) rich in water
Extra cellular volume
(20%) rich in water
15% constitute interstitial space and
5% the intravascular space.
19. EXAMPLE 1
Fluid Compartments
70 kg male: (70x 0.6)
TBW= 42 L
Intracellular volume = .66 x 42 = 28 L
Extracellular volume = .34 x 42 = 14 L
• Interstitial volume = .66 x 14 = 9 L
• Intravascular volume = .34 x 14 = 5 L
21. Fluid Requirements
Normal adult requires approximately 35cc/kg/d
“4,2,1” Rule l hr
First 10 kg= 4cc/kg/hr
Second 10 kg= 2cc/kg/hr
1cc/kg/hr thereafter
22. Normal daily losses and
requirements for fluids and
electrolytes
K+ (mmol)
Na+
(mmol)
Volume
(ml)
60
--
10
--
70
80
--
--
--
80
2000
700
300
300
2700
Urine
Insensible losses
(skin and respiratory
tract)
Faeces
Minus endogenous
Water
Total
24. WHAT IS THE AMOUNT?
In adults remember IVF rate = wt (kg) + 40.
70 + 40 = 110cc/hr
Assumes no significant renal or cardiac disease and NPO.
This is the maintenance IVF rate, it must be adjusted for any dehydration
or ongoing fluid loss.
Conversely, if the pt is taking some PO, the IVF rate must be decreased
accordingly.
Daily lytes, BUN ,Cr, I/O, and if possible, weight should
be monitored in patients receiving significant IVF.
25. Sodium requirement
Na: 1-3 meq/kg/day
70 kg male requires 70-210 meq NaCl in 2600 cc fluid per day.
0.45% saline contains 77 meq NaCl per liter.
2.6 x 77 = 200 meq
Thus, 0.45% saline is usually used as MIVF assuming no other
volume or electrolyte issues.
26. Potassium requirment
Potassium: 1 meq/kg/day
K can be added to IV fluids. Remember this increases osm load.
20 meq/L is a common IVF additive.
This will supply basal needs in most pts who are NPO.
If significantly hypokalemia, order separate K supplementation.
Oral potassium supplementation is always preferred when
feasible.
Should not be administered at rate greater than
10-20 mmol/hr
30. Iv Fluids
Colloid solutions
Containing water and large proteins and
molecules
tend to stay within the vascular space
Crystalloid solutions
containing water and electrolytes.
31. Colloid solutions
- IV fluids containing large proteins and
molecules
- tend to stay within the vascular space and
increase intravascular pressure
-very expensive
- Examples: Dextran, hetastarch, albumin…
32. Crystalloid solutions
Contain electrolytes (e.g.,sodium, potassium,
calcium, chloride)
Lack the large proteins and molecules
Come in many preparations and volum
Classified according to their “tonicity:
” 0.9% NaCl (normal saline), Lactated Ringer's
solution isotonic,
2.5% dextrose hypotonic
D5 NaCl hypertonic
35. Normal saline fluid (NS 0.9%)
(NS) — is the commonly-used term for a
solution of 0.90% w/v of NaCl, about 300
mOsm/L or 9.0 g per liter
Na is154 and only CL 154
No K, NO others
36. Hartmann’s fluid
One litre of Hartmann's solution contains:
131 mEq of sodium ion = 131 mmol/L.
111 mEq of chloride ion = 111 mmol/L.
29 mEq of lactate = 29 mmol/L.
5 mEq of potassium ion = 5 mmol/L.
4 mEq of calcium ion = 2 mmol/L .
37. Ringer lactate fluid
One litre of lactated Ringer's solution
contains:
130 mEq of sodium ion = 130 mmol/L
109 mEq of chloride ion = 109 mmol/L
28 mEq of lactate = 28 mmol/L
4 mEq of potassium ion = 4 mmol/L
3 mEq of calcium ion = 1.5 mmol/L
39. CASE FOR PRACTICE
FLUID 35/KG/DAY,
Na: 1-3 meq/kg/day.,
K: 1 meq/kg/day
70 kg male requires 2450 cc fluid per day, 70-210 meq Na
0.45% saline contains 77 meq NaCl per liter.
2.6 x 77 = 200 meq
Thus, 0.45% saline is usually used as MIVF assuming no other
volume or electrolyte issues.
40. Terminologies:
A solvent is the liquid where particles dissolves in (e.g. Water) that can be measured in liters and
milliliters
Solutes are the dissolving particles
A molecule is the smallest unit with chemical identity (e.g. Water consist of one oxygen and two
hydrogen atoms = water molecule)
Ions are dissociated molecule into parts that have electrical charges ( e.g. NaCl dissociates into Na+ and Cl-)
Cations are positively charged ions (e.g. Na+) due to loss of an electron (e-) and anions are
negatively charged ions (e.g. Cl-) due to gain of an electrone (e-)
Electrolytes are interacting cations and anions (e.g. H+ + Cl- = HCL [hydrochloric acid])
A univalent ion has one electrical charge (e.g. Na+). A divalent ion has two electrical charges (e.g.
Ca++)
41. Molecular weight is the sum of atomic weights of different parts of a molecule (e.g. H+ [2
atoms] + O2 [16 atoms] = H2O [18 atoms])
A mole is a measuring unit of the weight of each substance` in grams (e.g. 1 mole of Na+ = 23 grams, 1
mole of Cl- = 35 grams, 1 mole of NaCl = 58 grams). It can be expressed in moles/L, millimoles x 10-3/L,
micromoles x 10-6/L of the solvent.
Equivalence refers to the ionic weight of an electrolyte to the number of charges it carries (e.g. 1
mole of Na+ = 1 Equivalent, whereas 1 mole of Ca++ = 2 Equivalents). Like moles, equivalence can also be
expressed in milliequivalent/L and microequivalent/L of the solvent.
Osmosis is the movement of a solution (e.g. water) through a semi permeable membrane from the lower
concentration to the higher concentration.
Osmole/L or milliosmole/L is a measuring unit for the dissolution of a solute in a solvent
Osmotic coefficient means the degree of dissolution of solutes (molecules) in a solvent (solution). For example
the osmotic coefficient of NaCl is 0.9 means that if 10 molecules of NaCl are dissolved in water, 9 molecules will
dissolve and 1 molecule will not dissolve.
42. Osmolarity is the dissolution of a solute in plasma measured in liters, whereas
Osmolality is the dissolution of a solute in whole blood measured in kilograms. Therefore,
Osmolality is more accurate term because dissolution of a solute in plasma is less inclusive
when compared to whole blood that contains plasma (90%) and Proteins (10%).
Gibbs – Donnan Equilibrium refers to movement of chargeable particles through a semi
permeable membrane against its natural location to achieve equal concentrations on either side
of the semi permeable membrane. For example, movement of Cl- from extra cellular space
(natural location) to intracellular space (unusual location) in case of hyperchloremic metabolic
acidosis because negatively charged proteins (natural location in intravascular space) are large
molecules that cannot cross the semi permeable membrane for this equilibrium.
Tonicity of a solution means effective osmolality in relation to plasma (=285 milliosmol/L).
Therefore, isotonic solutions [e.g. 0.9% saline solution] have almost equal tonicity of the plasma,
hypotonic solutions [e.g. 0.45% saline solution] have < tonicity than plasma, and hypertonic
[e.g. 3% saline solution] solutions have > tonicity than plasma.
44. Hypokalemia:
Occurs when serum K+<3 mEq/L.
Treatment involves KCl i.v. infusion or
orally.
THE MOST COMMON SURGICAL
ABNORMALITY
Should not be administered at rate
greater than 10-20 mmol/hr
46. Hyperkalemia:
Diagnosis is established by ↑ serum K+>6
meq/L and ECG changes.
Causes include increase K+ infusion in
IVF, tissue injury, metabolic acidosis,
renal failure, blood transfusion, and
hemodialysis.
Arrythmia is the presentation
48. Management of high K
Diagnosis is established by ↑ serum K+>6
meq/L and ECG changes.
Treatment includes 1 ampule of D50% +
10 IU Insulin intravenously over 15
minutes, calcium exalate enemas, Lasix
20-40 mg i.v., and dialysis if needed.
49. Sodium Excess (Hypernatremia):
Diagnosis is established when serum sodium >
145mEq/L.
this is primarily caused by high sodium infusion
(e.g. 0.9% or 3% NaCl saline solutions).
Another but rare cause is
hyperaldosteronism.( What is function?)
Patients with CHF, Cirrhosis, and nephrotic
syndrome are prone to this complication
Symptoms and sign of are similar to water
excess.
50. Causes hypernatreamia
Reduced intake
Fasting
Nausea and vomiting
Ileus
Reduced conscious level
Increased loss
Sweating (pyrexia, hot environment)
Respiratory tract loss (increased ventilation,
administration of dry gases)
Burns
Inappropriate urinary water loss
Diabetes insipidus (pituitary or nephrogenic)
Diabetes mellitus
Excessive sodium load (hypertonic fluids, parenteral
nutrition)
51. Management of HN
Diagnosis is established when serum
sodium > 145mEq/L.
Treatment include water intake and ↓
sodium infusion in IVF (e.g. 0.45% NaCl
or D5%Water).
52. Sodium Deficit (Hyponatremia):
Causes are hyperglycemia, excessive IV
sodium-free fluid administration
(Corrected Na= BS mg/dl x 0.016 + P (Na) )
can be volum over load, normo, low
Hyponatremia with volum overload
usually indicates impaired renal ability to
excrete sodium
53. Treatment of hypo Na
Administering the calculated sodium needs in
isotonic solution
In severe hyponatremia ( Na less than
120meq/l): hypertonic sodium solution
Rapid correction may cause permanent brain
damage duo to the osmotic demyelination
syndrom
Serum Na sholud be increased at a rate
not exceed 10-12meq/L/h.
54. Water Excess:
caused by inappropriate use of hypotonic
solutions (e.g. D5%Water) leading to hypo-
osmolar hyponatremia, and Syndrome of
inappropriate anti-diuretic hormone
secretion (SIADH)
Look for SIADH causes :malignant tumors, CNS
diseases, pulmonary disorders, medications, and
severe stress.
55. The role of ADH:
ADH = urinary concentration
ADH = secreted in response to
osmo;
= secreted in response to vol;
ADH acts on DCT / CD to reabsorb water
Acts via V2 receptors & aquaporin 2
Acts only on WATER
56. Symptoms of EW
Symptoms of water excess develop slowly
and if not recognized and treated
promptly, they become evident by
convulsions and coma due to
cerebral edema
57. Signs of hypo /
hypervolaemia:
Signs of …
Volume depletion Volume overload
Postural hypotension Hypertension
Tachycardia Tachycardia
Absence of JVP @ 45o Raised JVP / gallop rh
Decreased skin turgor Oedema
Dry mucosae Pleural effusions
Supine hypotension Pulmonary oedema
Oliguria Ascites
Organ failure Organ failure
58. Treatment of EW
water restriction and infusion of isotonic or
hypertonic saline solution
In the SIADH secretion. Diagnosis of SIADH
secretion is established when urine sodium > 20
mEq/L when there is no renal failure,
hypotension, and edema. Treatment involves
restriction of water intake (<1000 ml/day) and
use of ADH- Antagonist (Demeclocycline 300-
600 mg b.i.d).
59. Water Deficit:
the most encountered derangement of
fluid balance in surgical patients.
Causes include Bleeding, third spacing,
gastrointestinal losses, increase insensible
loss (normal ≈ 10ml/kg/day), and
increase renal losses (normal ≈ 500-1500
ml/day).
60. Symptoms and Signs of WD
Symptoms of water deficit include feeling
thirsty, dryness, lethargy, and confusion.
Signs include dry tongue and mucous
membranes, sunken eyes, dry skin, loss of
skin turgor, collapsed veins, depressed
level of conciousness, and coma.
61. Signs of hypo /
hypervolaemia:
Signs of …
Volume depletion Volume overload
Postural hypotension
Tachycardia
Absence of JVP @ 45o
Decreased skin turgor
Dry mucosae
Supine hypotension
Oliguria
Organ failure
62. Diagnosis of WD
Diagnosis can be confirmed by ↑ serum
sodium (>145mEq/L) and ↑ serum
osmolality (>300 mOsmol/L)
63. Tratment of WD
If sodium is > 145mEq/L give 0.45% hypotonic saline solution,
if sodium is >160mEq/L give D5%Water cautiously and slowly
(e.g. 1liter over 2-4 hours) in order not to cause water excess.
Bleeding should be replaced by IVF initially then by whole blood or
packed red cells depending on hemoglobin level. Each blood unit
will raise the hemoglobin level by 1 g.
Third spacing replacement can be estimated within a range of 4-8
ml/kg/h.
Gastrointestinal and intraoperative losses should be replaced cc/cc.
IVF maintenance can be roughly estimated as 4/2/1 rule.
64. Hypercalcemia:
Diagnosis is established by measuring the
free Ca++ >10mg/dl.
In surgical patients hypercalcemia is
usually caused by hyperparathyroidism
and malignancy.
Symptoms of hypercalcemia may include
confusion, weakness, lethargy, anorexia,
vomiting, epigastric abdominal pain due to
pancreatitis, and nephrogenic diabetes
65. Management of high Ca
Diagnosis is established by measuring the
free Ca++ >10mg/dl.
Treatment includes normal saline infusion,
and if CA++>14mg/dl with ECG changes
additional diuretics, calcitonin, and
mithramycin might be necessary
66. Hypocalcemia:
Results from low parathyroid hormone after
thyroid or parathyroid surgeries,
low vitamin D,
pseudohypocalcemia (low albumin and
hyperventilation).
Other less common causes include pancreatitis,
necrotizing fascitis, high output G.I. fistula, and
massive blood transfusion.
67. Symptoms and signs of low Ca
may include numbness and tingling
sensation circumorally or at the fingers’
tips. Tetany and seizures may occur at a
very low calcium level. Signs include
tremor, hyperreflexia, carpopedal spasms
and positive Chvostek sign.
68. Treatment of low Ca
Treatment should start by treating the
cause. Calcium supplementation with
calcium gluconate or calcium carbonate
i.v. or orally. Vitamin D supplementation
especially in chronic cases.
69. Hypomagnesaemia:
The majority of magnesium is intracellular with
only <1% is in extracellular space.
It happens from inadequate replacement in
depleted surgical patients with major GI fistula
and those on TPN.
Magnesium is important for
neuromuscular activities. (can not correct
K nor Ca)
In surgical patients hypomagnesaemia is a
frequently missed common electrolyte
abnormality as it causes no major alerting
70. Hypermagnesaemia:
Mostly occur in association with renal
failure, when Mg+ excretion is impaired.
The use of antacids containing Mg+ may
aggravate hypermagnesaemia.
Treatment includes rehydration and renal
dialysis.
71. Hypophosphataemia:
This condition may result from :
-inadequate intestinal absorption,
-increased renal excretion,
-hyperparathyroidism,
- massive liver resection, and
-inadequate replacement after recovery
from significant starvation and catabolism.
72. Management of low phos
Hypophosphataemia causes muscle
weakness and inadequate tissue
oxygenation due to reduced 2,3-
diphosphoglycerate levels.
Early recognition and replacement will
improve these symptoms.
74. Prescribing fluids:
Crystalloids:( iso, hypo, hypertonic)
0.9% saline - not “ normal “ !
5% dextrose
0.18% saline + 0.45% dextrose
Others
Colloids:
blood
plasma / albumin
synthetics
75. The rules of fluid
replacement:
Replace blood with blood
Replace plasma with colloid
Resuscitate with colloid
Replace ECF depletion with saline
Rehydrate with dextrose
88. How much fluid to give ?
What is your starting point ?
Euvolaemia ? ( normal )
Hypovolaemia ? ( dry )
Hypervolaemia ? ( wet )
What are the expected losses ?
What are the expected gains ?
89. What are the expected
losses ?
Measurable:
urine ( measure hourly if necessary )
GI ( stool, stoma, drains, tubes )
Insensible:
sweat
exhaled
90. What are the potential
gains ?
Oral intake:
fluids
nutritional supplements
bowel preparations
IV intake:
colloids & crystalloids
feeds
drugs
91. Examples:
What follows is a series of simple - and
some more complex fluid-balance
problems for you
Answers are in the speakers notes.
92. Case 1:
A 62 year old man is 2 days post-colectomy. He
is euvolaemic, and is allowed to drink 500ml. His
urine output is 63 ml/hour:
1. How much IV fluid does he need today ?
2. What type of IV fluid does he need ?
93. Case 2:
3 days after her admission, a 43 year old
woman with diabetic ketoacidosis has a blood
pressure of 88/46 mmHg & pulse of 110 bpm.
Her charts show that her urine output over the
last 3 days was 26.5 litres, whilst her total
intake was 18 litres:
1. How much fluid does she need to regain a
normal BP ?
2. What fluids would you use ?
94. Case 3:
An 85 year old man receives IV fluids for 3 days
following a stroke; he is not allowed to eat. He
has ankle oedema and a JVP of +5 cms; his
charts reveal a total input of 9 l and a urine
output of 6 litres over these 3 days.
1. How much excess fluid does he carry ?
2. What would you do with his IV fluids ?
95. Case 4:
5 days after a liver transplant, a 48 year old
man has a pyrexia of 40.8oC. His charts for the
last 24 hours reveal:
urine output: 2.7 litres
drain output: 525 ml
nasogastric output: 1.475 litres
blood transfusion: 2 units (350 ml each)
IV crystalloid: 2.5 litres
oral fluids: 500 ml
96. Case 4 cont:
On examination he is tachycardic; his supine BP
is OK, but you can’t sit him up to check his erect
BP. His serum [ Na+ ] is 140 mmol/l.
How much IV fluid does he need ?
What fluid would you use ?
98. Normal physiology
Hydrogen ion is generated in the body by:
1-Protein and CHO metabolism
(1meq/kg of body weight)
2-Predominant CO2 production
It is mainly intracellular
PH depends on HCO3
CO2
99. Normal physiology
PH = log 1/[H+]
Normal PH range = 7.3 – 7.42
PH<7.3 indicates acidosis
PH>7.42 indicates alkalosis
