(精选)【持续性肾脏替代治疗CRRT英文精品课件】Patient Management Renal System教学课件.pptVIP

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2018-03-21 发布于天津
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(精选)【持续性肾脏替代治疗CRRT英文精品课件】Patient Management Renal System教学课件.ppt

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演示文稿演讲PPT学习教学课件医学文件教学培训课件

Treatment of Fluid Volume Excess Water and sodium restriction Diuretics Loop (furosemide [Lasix]) Thiazide (hydrochlorothiazide [HCTZ]) Potassium-sparing (spironolactone [Aldactone]) Carbonic anhydrase inhibitors (acetazolamide [Diamox]) Osmotic (mannitol [Osmotrol]) Disorders of Electrolyte Metabolism from Dialysis Sodium imbalances Potassium imbalances Calcium imbalances Magnesium imbalances Phosphorus imbalances Sodium Imbalances Hyponatremia Causes: Heart, liver, and renal failure cause excessive water retention. SIADH creates normal volume but low sodium. Treatment: Identify and correct underlying cause; diuretics, 3% NSS (to correct low sodium), and fluid restrictions if hypervolemic. Hypernatremia Causes: Dehydration, excessive sweating, decreased intake, diabetes insipidus, hyperaldosteronism (Cushing’s disease) Treatment: Correct underlying condition; diabetes insipidus (DDAVP), IV hypotonic solutions. Potassium Imbalances Hypokalemia Causes: Administration of diuretics like furosemide (Lasix), diarrhea, metabolic acidosis (H+ out of cell, K+ goes into cell), inadequate dietary intake (ETOH) and too much insulin Treatment: Find and treat the underlying cause. K+ supplementation in dietary, PO, or IV. Use caution when giving K+ IV. Always dilute in 50–100 mL give over 1-2 hr. Always use infusion pump. Monitor site for infiltration. Hyperkalemia Causes: ARF, CRF, too much oral/IV supplementation, improper phlebotomy technique (sudden, unanticipated change), acidosis, massive cellular damage (burns, trauma) Treatment: Dialysis with ARF/CRF. Gut binding drugs. Harder to treat than hypokalemia, so always check K+ levels before administration. Emergency treatment: Calcium IV, sodium bicarbonate IV (shifts K+ into cell), IV insulin and glucose Calcium Imbalances Hypocalcemia Causes: Removal of parathyroids, pancreatitis, ETOH, use of trisodium citrate (CRRT), decreased albumin Treatment: Increase dietary ingestion. Give calcium supplements. Calcium gluconat