水电解质失衡英语课件

NursingCareofclientwithAlterationsinFluidoverviewDistribution

tissueFluid

(15%)extracellularFluid（20%）plasma

(5%)

intracellularFluid(40%or30%)

女儿是水做的骨肉，男人是泥作的骨肉。我见了女儿，我便清爽；见了男子，便觉浊臭逼人ADREAMOFREDMANSION80％TheBalanceOfLiquidintakeAndOutputRegulationKidneyHypothalamus-PosteriorPituitary-ADHSystem(下丘脑-垂体-抗利尿系统）Renin-Angiotensin-Aldosteronesystem(肾素—血管紧张素--醛固酮系统)WaterandelectrolytebalanceClassificationofdehydrationsaltwaternormalhypertonichypotonicisotonicsaltwatersaltwatersaltwaterCommoncauseshemorrhage,vomiting,diarrhea,severewounddiuretictherapyburnsetcHypotonicDehydration[Definition]

Sodiumlossisgreaterthanwater.It'salsocalledchronicdehydration.Thelevelofsodiumbelow135mmol/L。Commoncausesdiarrhea(atleastafewdays)chronicillnessexcessivefluidreplacementrenalfailueHypertonicDehydration[Definition]Waterlossisgreaterthansodium.It'salsocalledchronicdehydration.Thelevelofsodiumgreaterthan150mmol/L。Commoncausesdysphagia(吞咽困难）(esophagealcancer)tubefeedingexcessivefluidreplacementprofusesweatingNursingCareNursingassessmentHistory

ageweightotherfactorsClinicalmanifestation1.Thirsy2.CardiovascularNanifestationmostreliableindicatorsheartrateincreasesperipheralpulseweakBPdecreases3.RenalManifestation---monitorurineouput,totalintakeandoutputweighttheclient(sametime,whenpossible,sameclothing)metabolicloss---0.25kg6.sodiumimbalancenausea,diarrhea,abdominalcrampingheadache,depression,dulledsensorium,personalitychanges,muscletwitching,evenconvulsionsandcomarapid,weak,threadypulse,lowerCVP,dizzinessNursingDianosisFluidVolumDeficitrelatedtoexcessivefluidlossorinadequatefluidintakeDecreasesCardiacOutputrelatedtodecreasedplasmavolumeRiskforImpairdeSkinIntegrityrelatedtodeficienciesofinadequatetissueperfusionActivityIntolerancerelatedtodizziness,hypotension.NursingImplementationInterventionsforfluidimbalance1.DietTherapy

mildtomoderatedehytrationmeasuresfluidintake2.OralRehydrationTherpymostcost-effctivewayspecialsolutionscontainingglucoseandelectrolyte王家岭煤矿，救援人员正在把软包装葡萄糖注射液塞进钻杆里送往井下3.DrugTherpywhensevereorlifethreateningmethod:intravenousfluidreplacementtype:dependonthetypeofdehydraton(isotonic,hypotonic)Calculatehowmuchfluidtoreplaceisbasedontheclient'sweightlossandclinicalmanifestationsTherateoffluidreplacementdependsonthedegreeofdehydrationandthdpresenceofpre-existioncardiac,pulmoanry,orrenalproblems.appropriateelectrolytecorrectthecauseofthedehydration4.MonitoringvitalsignsatleastperhourpulsebloodpressurecerntralvenouspressurerespiratoryrateurineoutputNursingEvaluationThenurseexpectstheclientwillMaitainafluidoutputapproximatelyequaltointakeMaitainregularcardiacrateandrhythmIdentifytheearlysignsandsymptomsoffluidimbalancesAvoidinjuryExperiencenomajorcomplicationsfromthecausesandtreamentoffluidimbalancesCaseAnalysisAadultman，weighed60kg,hadbeenfrequentlyvomittingfor3days.Hewasadmittedtotheemergengyas"AcuteIleus".Theclientdidn'thaveadequenturinevolume，about500～700ml/d,Laboratoryresults：Bp92/70mmHg,P96/mi