031-040.pdf

- PH 7,55.... Alkalosis - Paco2...49...... Acidosis - Hco3...35...... Alkalosis  Metabolic alkalosis partially compensated. balance‫ عشان يحاول يعمل‬acid ‫ بقي‬Paco2 ‫الن‬ - PH 7, 37....Normal - Paco2...52...... Acidosis - Hco3...32....Alkalosis Hco3 ‫ وال اقرب‬paco2 ‫اقرب لمين هل اقرب ل‬PH ‫ نشوف...

- PH 7,55.... Alkalosis - Paco2...49...... Acidosis - Hco3...35...... Alkalosis  Metabolic alkalosis partially compensated. balance‫ عشان يحاول يعمل‬acid ‫ بقي‬Paco2 ‫الن‬ - PH 7, 37....Normal - Paco2...52...... Acidosis - Hco3...32....Alkalosis Hco3 ‫ وال اقرب‬paco2 ‫اقرب لمين هل اقرب ل‬PH ‫ نشوف ال‬Base ,Acid ‫عشان نعرف هي‬ Acid‫ اى‬7,35 ‫ معنا كده هي اقرب‬7,37 ‫الن فيه هنا المثال‬  Respiratory acidosis with fully compensated. - PH ...7,43......Normal ……. alkalosis ‫اقرب لي‬ - Paco2...43.... normal - HCO3....... Alkalosis……. METABOLIC  Metabolic alkalosis fully compensated. 31 vElectrolytes  Potassium 𝐊 + )3.5- 5(  Function of 𝐊 +:  Priority: o pumps the heart and Muscles.  Hypokalemia: o Below 3.5  Manifestants: 1. Heart→ o low and Slow Pumps o Flat T wave o ST depression Wave. 2. Neuromuscular: Low and Slow 1. Shallow Respiration Most deadly 2. Decreased DTR 3. Muscle Clamping, Flaccid, paralysis, paralyzed. 3-Gi= Low and Slow o Constipation o Hypo active bowel sounds o Paralytic illuis, (Paralyzed intestine Priority Risk for SBO small bowel obstruction 32  Causes of Hypokalemia:  Fluid Loss means electrolyte Loss.  Diarrhea  Diuretics  Diet Low Potassium  ↑High aldosterone  DKA  Hyperkalemia: o over 5.0  Manifestations: 1) Heart o High Pumps o Peaked T wave, St Elevate o Sever Ventricular Fibrillation o Cardiac arrest o Hypo tension Brady Cardia 2-Neuro muscular→ High 1) Increased DTR 2) Paralysis, Paresthesia (numbness) (Tingling) 3) Muscle Weakness (General Feeling of heaviness) 3-Gi=High Pump Diarrhea, Hyperactive bowel Sounds 33  Causes Hyperkalemia o Renal Failure and Low aldosterone vSodium Na 135-145  Function of Sodium: - S-Swells the body With Fluid.  Maintains - Blood Pressure - Blond Volume - PH balance. v Hyponatremia: - Below 135  Manifestations:  Brain: - Low slow Inside the Bain - Headache, cerebral edema - Mental States Changed - Seizures Coma.  Muscular: - Low and slow. - Fatigue, Muscle Clamps - Respiratory Low and slow 34 - Respiratory arrest  Causes of Hyponatremia: - Sweating - Excess water intake. (running in the extreme heat) - SIDH ↑ increase excess ADH↑ - vomiting | Darrah - Diuretics, Diuresis - Low aldosterone - Diet low in Salt. v Hypernatremia: - Over-145  Manifestations: - Body Big - Edema (Very swollen body). - Flushed Red Rosey skin. - increased muscle Tone. - Swollen dry Tongue. - Nausea vomiting  Causes of Hypernatremia: - Low ADH (antidiuretic hormones) (Di: Diabetes insipidus) - Rapid respirations - Watery diarrhea makes the body dry so high sodium. - Loss of Thirst he cannot explain Thirst, Immobility Pat. 35 vChlorride (CL 97-167)  Function Maintains - Blood Pressure. - Blood Volume. - PH bedance. v Hyperchloremia - Over 107  Manifestations: - - swollen and dry tongue. Nausea, vomiting. - Alkalosis → vomiting  Hypochloremia: - Below 97  Manifestations: - Fatigue Muscle cramps - Fever only different vMagnesium (Mg 1.3/2.1)  Function: - Mellow The muscle.  Hypomagnesaemia: - Below 1.3  Manifestations:  Heart o Low Mellow Excited o Torsade's de Points ECG Leading to V. Fib (Ventricular Fibrillation) 36 o DTR Low Mellow Excited o Hyperreflexia increased DTR  Causes Of Hypomagnesaemia: o Crohn’s disease o celiac disease. o Crohn’s disease and celiac disease are separate conditions that both affect the gastrointestinal (GI) tract. They can cause similar symptoms, making it difficult to tell them apart without diagnostic testing. In some cases, a person can develop both Crohn's and celiac. v Hypermagnesemia - Over 2.1  Manifestations: 1. Heart → High Mellow - Heart Block - Hypertension, Brady Cardio, low blood pressure and low heart rate. 2. DTR: High Mellow - Hyporeflexia (decreased DTR) 3. lungs, Gi= High mellow - depressed respirations 4- Hypoactive Bowel Sounds. v Causes of Hypermagnesemia: - Renal Feline. - Alcoholism 37 - Malnourishment v Calcium (CA 9 - 10.5)  Function. 1. KEEPS the 3 B. Strong Bon, Blood Clotting, Beats (heart)Contacts The Muscle.  Hypocalcemia: o Below 9.0  Manifestations: 1) T-trousseaus Sign o Twerking arm When RP Cuffing o Tetany muscle spasms all over 2) (c) Chvostek’s Sigh o Cheek Smile When stroking Face. 3) Diarrhea 4) Weak Bones, Blood Clotting Beats  Causes of Hypocalcemia o Hypoparathyroidism: o Low PTH lead to Low Calcium o Renal Failure: o chronic kidney disease CDK. o low Ca due to retention of phosphate Causes Hyperphosphatemia. v Hypercalcemia  Over 10.5 38  Manifestations: - kidney Stones, moans groans) Renal Calculi) - Constipation - Bone pain - Sever Muscle Weakness Lethargy - Calcium Control by PTA v Causes - Hyperparathyroidism - High PTH lead to high Calcium. - Cancer - PTH→ Parathyroid hormone. v Phosphate (3- 4.5)  Function o Inverse relationship with calcium - Ca High= Phosphate Low - Ca Low = Phosphate High  Hyperphosphatemia o over 4,5  Manifestations: - Think low calcium. - Trousseaus SIGN, tetany - Chvostek's - weak (Bones, blood, Beasts).  Cause of Hyperphosphatemia - Renal failure chronic kidney disease. 39  Hypophosphatemia o Below 3,0  Manifestations: - Think High Calcium signs. - Kidney Stones (Means, groans) it’s Called Renal Calculi - Constipation, Bone Pain, Sever Musca Weather lethargy.  Causes of Hypophosphatemia:  Hyperparathyroidism → Lead to High PTH = high on Calcium - Genetic and Cancer. v Hemostats:  The body being in Harmony and all systems are Within Normal limits.  Therapeutic range: o The range at which a Therapeutic Regimen is Working it's Best. vWrite 10 Times Before, After Study  Foods rich in Electrolytes. - Potassium: (K 3.5- 5)  Any fruit+ Green, Leafy" Veggies (Spinach Salt Substitutes) - Sodium (Na 135-145)  Table salt, cheese, spices, canned, processed food - Magnesium (1.3 -2.1)  spinach, almonds, yogurt, green vegetables. - Calcium 9- 10,5  Milk, Chee’s, green Veggies. - Phosphate 3-4.5  Dairy, Meats, beans 40