Fluid electrolyte and acid base

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Fluid electrolyte and acid base by Mind Map: Fluid electrolyte and acid base

1. Assessment: Fluid and electrolyte

1.1. Health history

1.1.1. Vomiting

1.1.2. Diagnosis kidney

1.1.3. Disease diabet - CHF

1.1.4. Poisoning, burn

1.1.5. Medication use :diuretics

2. ๐ŸฅDiagnostic test and procedure

2.1. Serum hematocrit แž…แžปแŸ‡แž‘แžถแž”

2.2. Serum creatinine แž€แžพแž“แžกแžพแž„

2.3. Blood urea nitrogen (BUN) แž€แžพแž“แžกแžพแž„

2.4. Serum albumin แž€แžพแž“แžกแžพแž„

2.5. Serum electrolyte

2.6. Urine tests

2.6.1. Specific gravity 1.010 1.025 แž”แŸ’แžšแžˆแž˜แž€แžถแžšแž”แžถแžแŸ‹แž”แž„แŸ‹แž‡แžถแžแžทแž‘แžนแž€

2.6.2. แžแžผแž…แž‡แžถแž„. 1.010 แž”แŸ’แžšแžˆแž˜แž€แžถแžšแž›แžพแžŸแž‡แžถแžแžท

3. Physical assessment

3.1. General appearance

3.1.1. Skin . Cool . Pallor . Skin tugor or edema

3.1.2. Vital signs

3.1.2.1. BT : fever

3.1.2.2. RR :deep tachypnea

3.1.2.3. RR:Tachycardia

3.1.2.4. BP : low or high

3.2. แžŸแž‰แŸ’แž‰แžถแž“แŸƒแž€แžถแžšแž”แžถแžแŸ‹แž”แž„แŸ‹แž‡แžถแžแžทแž‘แžนแž€๐Ÿ’ฆ๐Ÿ’ง

3.2.1. แžŸแŸ’แž”แŸ‚แž€แžŸแŸ’แž„แžฝแž

3.2.2. Capillary refill

3.2.3. แžšแžœแžพแžšแžœแžถแž™

3.2.4. แžŸแŸ’แžšแž€แž‚แžธแžกแžผ

3.2.5. แž“แŸ„แž˜แžแžทแž…

4. Assessment hypovolemia and dehydration

4.1. Hypovolemia

4.1.1. แž‡แžถแžแžทแž‘แžนแž€แž€แŸ’แž“แžปแž„แžแŸ’แž›แžฝแžฝแž“แžแžทแž…แž‡แžถแž„แž‡แžถแžแžทแž‘แžนแž€แž’แž˜แŸ’แž˜แžแžถ

4.1.2. แž”แžถแžแŸ‹แž”แž„แŸ‹แž‡แžถแžแžทแž‘แžนแž€แž€แŸ’แž“แžปแž„แžŸแžšแžŸแŸƒแžˆแžถแž˜

4.1.3. แžแž˜แžแž™แž“แŸƒแž€แžถแžšแž•แžนแž€แž‘แžนแž€

4.2. Dehydration

4.2.1. Primary dehydration

4.2.1.1. แžแž˜แžแž™แž“แŸƒแž€แžถแžšแž•แžนแž€แž‘แžนแž€

4.2.1.2. แžขแŸ’แž“แž€แž‡แž˜แŸ’แž„แžบcoma แž˜แžทแž“แžขแžถแž…แž•แžนแž€แž‘แžนแž€แž”แžถแž“แžŠแŸ„แž™แžแŸ’แž›แžฝแžฝแž“แžฏแž„

4.2.2. Secondary dehydration

4.2.2.1. แž”แžถแžแŸ‹แž”แž„แŸ‹แž‡แžถแžแžทแž‘แžนแž€ แž“แžทแž„ electrolytes แž…แŸ’แžšแžพแž“

4.2.2.2. Vomiting; diarrhea

4.2.2.3. แž“แŸ„แž˜แž…แŸ’แžšแžพแž“แž แžฝแžŸแž”แŸ’แžšแž˜แžถแžŽ

5. Nursing diagnosis

5.1. แž€แžถแžšแžแž™แž…แžปแŸ‡แž‘แžทแž“แŸ’แž“แž•แž›แž”แŸแŸ‡แžŠแžผแž„แžŠแŸ‚แž›แž‘แžถแž€แŸ‹แž‘แž„แž“แžนแž„แž€แžถแžšแž”แžถแžแŸ‹แž”แž„แŸ‹ ECF แž…แŸ’แžšแžพแž“แž–แŸแž€ แžฌแž€แžถแžšแž˜แžทแž“แž•แžนแž€แž‘แžนแž€

5.2. แž€แžถแžšแžแž™แž…แžปแŸ‡แž‘แžทแž“แŸ’แž“แž•แž›แž”แŸแŸ‡แžŠแžผแž„แžŠแŸ‚แž›แž‘แžถแž€แŸ‹แž‘แž„แž“แžนแž„แž€แžถแžšแž”แžถแžแŸ‹แž”แž„แŸ‹ ECF แž…แŸ’แžšแžพแž“แž–แŸแž€ แžฌแž€แžถแžšแžแž™แž…แžปแŸ‡แž€แžถแžšแž‘แž‘แžฝแž›แž‘แžถแž“แž‡แžถแžแžทแž‘แžนแž€

5.3. แž•แž›แžœแžทแž”แžถแž€แžŠแŸ‚แž›แžขแžถแž…แž€แžพแžแž˜แžถแž“

5.3.1. Hypovolemic shock

6. แž‘แžนแž€แž˜แžถแž“แŸขแž•แŸ’แž“แŸ‚แž€แž’แŸ†แŸ—

6.1. แž‘แžนแž€แž€แŸ’แž“แžปแž„แž€แŸ„แžŸแžทแž€แžถแž˜แžถแž“แž”แŸ’แžšแž แŸ‚แž›แŸฆแŸ %แž‘แŸ…แŸงแŸ %แžฌแŸข/3แž‘แžนแž€แžŸแžถแžšแž–แžถแž„แŸ’แž‚แž€แžถแž™

6.1.1. แž‘แžนแž€แž€แŸ’แž“แžปแž„แžŸแžšแžŸแŸƒแžˆแžถแž˜แž˜แžถแž“แž‘แž˜แŸ’แžšแž„แŸ‹แž‡แžถPlasma

6.1.2. แž‘แžนแž€แž…แž“แŸ’แž›แŸ„แŸ‡แž€แŸ„แžŸแžทแž€แžถ

6.1.3. 3rd space

6.1.3.1. 3rd space แž˜แžถแž“แžŠแžผแž…แž‡แžถ

6.1.3.1.1. แžŸแŸ’แžšแŸ„แž˜แžŸแžฝแž แžŸแŸ’แžšแŸ„แž˜แž”แŸแŸ‡แžŠแžผแž„ แž€แŸ’แž“แžปแž„แž—แŸ’แž“แŸ‚แž€ แž“แžทแž„ แž‘แžนแž€แž”แŸ’แžšแž˜แžถแžแŸ‹

6.2. แž‘แžนแž€แž€แŸ’แžšแŸ…แž€แŸ„แžŸแžทแž€แžถแž˜แžถแž“แž”แŸ’แžšแž แŸ‚แž›แŸฃแŸจ%แž‘แŸ…แŸฃแŸฉ%แžฌแŸก/แŸฃ

7. แž€แžถแžšแž”แŸ†แž•แŸ’แž›แžถแžŸแŸ‹แž‘แžธแžŸแž“แŸƒแž‘แžนแž€แž˜แžถแž“แŸฃแž€แžแŸ’แžแžถ

7.1. แž”แž“แŸ’แžŸแžถแž™

7.2. Osmosis

7.3. Na+ K+ pump

8. Input

8.1. 2.2 l/day

8.2. 0.3L/day Metabolism =Glucose +O2=>co2+H2O +ATP

9. Out put

9.1. แž…แŸแž‰แžแžถแž˜แžŸแŸ’แž”แŸ‚แž€ แž“แžทแž„ แžŸแžฝแž 0.9L/day

9.2. Urine 1.5L/day

10. แž€แŸ„แžŸแžทแž€แžถแžšแžแžฝแžšแž€แŸ’แž”แžถแž›แž˜แžถแž“แž“แžถแž‘แžธแžแž˜แŸ’แžšแžผแžœแž‡แžถแžแžทแž‘แžนแž€

10.1. แž”แž‰แŸ’แž‡แžถแž•แž›แžทแžhormone (ADH) แž€แžปแŸ†แžฒแŸ’แž™แžแž˜แŸ’แžšแž„แž“แŸ„แž˜แž”แž‰แŸ’แž…แŸแž‰แž‘แžนแž€แž“แŸ„แž˜

10.2. แž”แž‰แŸ’แž‡แžถแž”แž‰แŸ’แžˆแž”แŸ‹แžฒแŸ’แž™แž•แž›แžทแžhormone (ADH) แžฒแŸ’แž™แžแž˜แŸ’แžšแž„แž“แŸ„แž˜แž”แž‰แŸ’แž…แŸแž‰แž‘แžนแž€แž“แŸ„แž˜

10.3. แžŠแžพแž˜แŸ’แž”แžธแžฒแŸ’แž™แž˜แžถแž“แž€แžถแžšแž‡แŸ†แžšแžปแž‰แž€แžถแžšแž•แžนแž€แž‘แžนแž€ แž–แžนแž„แž‘แŸ… Renin

11. Nursing intervention

11.1. แž€แŸ‚แžแž˜แŸ’แžšแžผแžœแž˜แžผแž›แž แŸแžแžปแžŠแŸ‚แž›แž’แŸ’แžœแžพแžฒแŸ’แž™แž”แžถแžแŸ‹แž”แž„แŸ‹แž‡แžถแžแžทแž‘แžนแž€

11.1.1. แžŠแŸ„แž™แžŸแžถแžšแžšแžถแž‚ แžฌ แž€แŸ’แžขแžฝแž

11.1.2. แž€แžถแžšแž”แžถแžแŸ‹แž”แž„แŸ‹แžˆแžถแž˜

11.1.3. Electrolytes

11.2. แž€แŸ‚แžแž˜แŸ’แžšแžผแžœแž‡แžถแžแžทแž‘แžนแž€

11.2.1. Adults ๐Ÿ‘จ 2ml/kg/hr

11.2.2. Children ๐Ÿ‘ฆ : 4 - 2 - 1 ( ml/kg/hr)

11.2.2.1. 1- 10kg แž‚แžปแžŽแž“แžทแž„ 4 แžงแž‘แžถแž แžšแžŽแŸ children 8kg 8 *4 =32ml/hr (IVF)

11.2.2.2. 11-20kg แž‚แžปแžŽแž“แžทแž„ 2 แžงแž‘แžถแž แžšแžŽแŸ children 15kg 10*4 + 5*2 = 50ml/hr

11.2.2.3. >20kg แž‚แžปแžŽแž“แžทแž„ 1แžงแž‘แžถแž แžšแžŽแŸ children 23kg 10*4+10*2+3+1 =63ml/hr