By Richard Arthur Preston
Univ. of Miami, FL. Concise guide on fixing difficulties touching on advanced fluid, electrolyte, and acid-base problems. For scientific scholars, interns, citizens, nurses and nurse practitioners, and first-year nephrology fellows. Softcovers.
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Additional resources for Acid-Base, Fluids, and Electrolytes Made Ridiculously Simple (1st Edition)
The osmolality should be checked: A low measured osmolality indicates hyponatremia with hypotonicity and excludes pseudohyponatremia and hyponatremia with hypertonicity. History Perform a careful history to search for causes of ECFV depletion (especially recent vomiting). Ask for a history consistent with congestive heart failure, nephrotic syndrome, chronic renal failure or cirrhosis, ingestion of thiazide diuretics or any of the conditions or medications listed in Fig. 3-2. What put this patient at risk for hyponatremia?
Renal failure Water restriction. Restrict water only if hyponatremia is present. 9% saline. Usually in setting of vomiting. 9% saline. Edematous states Water restriction for hyponatremia. Sodium restriction and loop diuretics to remove edema. Restrict water only if hyponatremia is present. Thiazide diuretics Stop thiazides. Replace sodium (orally is usually sufficient) and potassium. Correct hypokalemia. Thiazides should not be given to any patient with hyponatremia. Increased ADH Water restriction.
I CHAPTER 2. 45% Saline. What do these solutions contain, and what are they used for? Each fluid has its own special uses and indications. This chapter tries to provide a general approach to the question: Which solution for which situation? The most commonly used IV solutions are summarized in Fig. 2-1. A few general comments: 1) Sodium chloride (saline) solutions that have tonicities close to that of plasma are termed isotonic. 9% saline and Ringer's Lactate. These solutions are used when it is desired to expand the extracellular fluid volume (ECFV).