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te

ACTIVI
TYNO.8
SUPPORTI
NGPHYSI
OLOGICRESPONSES:FLUI
DANDELECTROLYTE&ACI
D
-BASEBALANCE/OXYGENATI
ON

Answert he f
oll
owi
ngst
artup
act
ivi
ti
esrel
atedtot
hese2concept
s.

A.CONCEPTONFLUI
DANDELECTROLYTE&ACI
DBASEBALANCE

K I D N E Y
E L E C T R O L Y T E

I N T R A V E N O U S F L U I D S C E L L
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 NORTHWESTERNUNI
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B.CONCEPTONOXYGENATI
ON

Unscr
ambl
ethewor
dsbel
ow,
placey
ouranswerbesi
dei
t.

XYOEGTNIOAN 1.Processofsuppl yingox ygentoall

bodytissues.
NAPEA 2.Cessat i
onofbr eathing.
YDPAESN 3.Dif
ficultyorlaboredbr eat
hing.
OPYHAIX 4.I
nsuf f
icientoxygenat i
ontot i
ssues.
NOGYXE HEAPYTR 5.Admi nistrat
ion of oxy gen at
concentrationsgreaterthant heroom
ai
r.
1.OXYGENATI ON
2.APNEA
3.DYSPNEA
4.HYPOXIA
5.OXYGENTHERAPY

1.I
denti
fyone(1)el ectroly
teimbalance:
a.Defi
net hei mbalance.
b.Manifestations-giveatleast3t hendiscuss
c.Ri
skfact ors-giveatleast3t hendiscuss
d.Niur
singi nterventi
ons-giveatleastfi
v e(5)

a.HYPOKALEMI A
b.MANIFESTATI ON
 Muscl eweaknessandcr aps
-Muscl e cramps ar e sudden,uncont roll
ed cont r
actions oft he
muscl es.Theycanoccurwhenbl oodpot assium levelsar elow and
canbepai nf
ul.
 Tingli
ngandnumbness
- Though mor e common i n peopl e wi th high pot assium,or
hyperkalemia,thosewi t
hpot assi
um def iciencymayal soexper i
ence
persistentti
nglesandnumbness.Thi sisknownaspar esthesiaand
usuallyoccursinthehands, arms, l
egs,andf eet.
 Polyuria
-Pol yuriais a conditi
on wher ey ou pee mor et han usual .Low
potassium level
smayi mpai ryourkidneys’ abi
li
tytoconcent rateuri
ne
and bal ance the blood’s el
ectroly
t elevels,leading toi ncr
eased
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urination.Youmayal sonot i
cei ncr easedt hirst ,knownaspol ydipsi a.
c.RISKFACTORS
 Hear tfai lur e
-Hy pokal emi ai sassoci ated wi thi ncr eased r iskofar rhythmi ai n
pat i
ent swi thcar diov ascul ardi sease,aswel lasi ncreasedal l-
cause
mor t
ality, car diov ascul armor t
alityandhear tfai l
ur emor tali
ty.
 Hy pertensi on
-Itmi ghtr esul tf rom ani ncr easei nur inar ylossofpot assi um wi tht he
useofant i
-hy per tensivedr ugs,suchat hi azidement ionedabov e,
whi ch ar e used t o bl ock t he i ncreased r eabsor pti
on ofsodi um
associ at edwi t
hhy per t
ensi on.
 Lowbodymax( BMI )
-Associ at ed wi t h angi otensin conv er ti
ng enzy me i nhi bitors and
angi otensi nI Ir ecept orblocker st r
eat ment s.
d.INTERVENTI ON
 1.Pl acet hepat ientonhi ghpot assium di etaspert hephy sician's
order .
-Tor epl acel ostbyt hebody .Ther ecommendeddi etaryr eplacement
forpot assi um i s40t o60mEq/ L/day .
 2.St artast ri
cti nputandout putmoni toring.
-Toaccur atelymeasur et hei nputandouputoft hpat i
ent.
 3.I fthepat ienti sondi ur eticsr egi men,swi tcht opot assium- spar ing
diureticsaspr escr ibed.
-Toachi ev et het her apeut icgoalofdi ureticswi t
houtcont r
ibutingt o
furtherpot assi um l oss.
 4.Admi nist erasl owi ntrav enouspot assi um sol utionaspr escr i
bed.
-A sl ow i nt ravenous pot assi um sol ution i s gi ven t or aise t he
pot assium l ev el i
nt hebl oodst ream.
 5.Obt ai ndai lybl oodsampl ef rom t hepat i
ent .
-Biochemi stryi sneededt ocheckf ort hel ev el ofser um pot assi um.

2.I
denti
fyone( 1)r
espiratorydisordert hatcanaffectoxy
genat
ion.Youshoul
d
beabl
et o:
a.Definethedisorder
b.Giveatleast3mani festati
ons-di scusseach
c.Giveatleast3r i
skf actors-discusseach
d.Giveatleast5nur singinterventions
a.EMPHYSEMA
b.MANIFESTATI ON
 Longt er m coughor"smoker '
scough
-Tightnessorpai niny ourchestcouldbecausedbyemphy semaorhear
tdisease
thatdev elopsasaresultofemphysema.
 Wheezi ng
-Theai rwaysthatall
ow ox y
gent ofl
ow toy ourl
ungsar eoftenmorenarr
ow than
normal.Ast heai
rstrugglestogetthr
ought heset
hinnerpassageway
s,i
tcausesthe
air
waywal l
stovi
brat
e.Thev i
brat
ionproducesawhistli
ngsoundknownaswheez i
ng.

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 Shortnessofbr eath
-Thei nnerwal l
soft helungs'airsacs(alveol
i)aredamaged,causi
ngthem to
eventuall
yrupture.Thiscreatesonelar
gerairspaceinst
eadofmanysmallonesand
reducest hesurfaceareaav ai
labl
eforgasexchange.Emphysemaisalungcondi
ti
on
thatcausesshor tnessofbreath.
c.RISKFACTORS
 Smoki ng
-Emphy semai smostl ikel ytodev elopi nci garett
esmoker s,butci garandpi pe
smoker sal soar esuscept ible.Ther i
skf oral ltypesofsmoker si ncreaseswi t
ht he
numberofy ear sandamountoft obaccosmoked.
 Ex posur et oindoorandout doorpol l
ution
-Br eat hingi ndoorpol l
ut ant s,suchasf umesf r
om heat ingf uel,aswel lasout door
pol l
ut antscarexhaust ,fori nstancei ncreasesy ourr i
skofemphy sema.
 Age
- Al thought hel ungdamaget hatoccur si nemphy semadev elopsgr adually,most
peopl e wi tht obacco- related emphy sema begi nt o ex per i
ence sy mpt oms oft he
diseasebet weent heagesof40and60.
d.INTERVENTI ON
 1.Asssesst hepat ient'
sv it
alsi gnsandchar act eri
sti
csofr espirationsatl eastev er
y4
hour s.Assessbr eat hsoundsv i
aauscul tati
on.
-Toassi sti ncr eatinganaccur atedi agnosi sandmoni t
oref f
ect ivenessofmedi cal
treatment .Wheezi ngbr eat hsoundsar ei mpor tantsignsofemphy sema.
 2.Suct ionsecr etions.
-Tohel pcl eart hickphl egm t hatt hepat i
ent sisunabl etoex pector ate.
 3.El ev atet heheadoft hebedandassi stt hepat ientt o assumesemi -
Fowl er'
s
posi tion.
-Headel ev ationandpr operposi ti
oni nghel pi mprovet heex pansi onoft hel ungs,
enabl ingt hepat i
entt obr eat hemor eef fectively.
 4.Admi nistert hepr escr ibedemphy semamedi cations(e.g.,bronchodi l
at ors,steroids,
orcombi nat ioni nhalers/nebul izer s)andant i
bioticmedi cations.
-Br onchodi lators: Todi lateorr elaxt hemuscl esont heai rway s.
Ster oids: Tor educet hei nf l
ammat i
oni nt hel ungs.
Ant i
bi ot i
cs: Tot reatbact erial i
nfect i
oni fpr esent .
 5.Admi nistersuppl ement alox ygen, aspr escribed.Discont inuei fSpO2l evelisabov e
thet ar getr ange, orasor der edbyt hephy si
cian.
-Toi ncr easet heoxy genl ev elandachi eveanSpO2v aluewi thint het argetr angeof
88t o92%

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