הפרעות אלקטרוליטים.pdf

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  • 5/21/2018 .pdf

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    ,

    ,RN,MA

    -135-145 meq/l - - -":ADH, Renin-Angiotensin-

    Aldosteron system

    >135meq/l :

    -

    ,-

    :),(' 1.2.:'3. - - -SIADH

    )

    ):>48

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    ,3. ,4.,5. 6. 7.

    :

    !!! !!!

    : PO,PZ,IV1. -

    IV NaCl 0.9%, Ringers Lactated sol

    .2 12 meq/l-( )Demyelination

    :IV NaCl 3.

    )"800(4..5SIADH:, +fusid.6AVP antagonist- IV Conivaptane

    (Vaprisol)

    -

    ( )

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    :.1 2.

    : 1..2

    :1. (

    ) 2.3. 4..5Diabetes Insipidus

    .6 , (IVNaBicarbonat(

    :1. 2.: 3.--- - -

    :Na > 145 meq/l

    Osm (bl) > 300 mosm/lOsm (ur)

    : !!!

    )(1.

    (IV Glu 5%)

    2.

    3. 0.5-1 meq/h

    .4Desmopressin (Minirin)Diabetes Insipidus

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    :1.2. 3. 4.5.

    DI - SIADH

    Na/Osm (Ur)

    Na/Osm (Bl)

    DISIADH

    - :3.5-5.0 meq/l- -- -

    ) )-"-RAAS

    >3.5 meq/l:1..2 :,,,('- )-((Cushing dis - -

    :,1. ,2. 3.4.

    TU

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    5/105

    :1.2. PO/IV.3 ) , , (-

    :+1.2.3.

    :IV1. IM ,2.

    .3 : 20 meq/100 cc/h: 4. ,20 meq/100 cc 5.

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    )(1. Kayexalate2.

    :1. )(2. .3IV Calcium gluconate.4IV NaBicarbonate.5IV Reg Insulin + glucose.6IV Fusid.7Inh Ventoline.8Kayxalate9.

    :1. 2. 3. 4.

    99 %1 % - '

    ( ) 8.6-10.2 mg/dl -++ Ca

    1.1-1.3 mmol/l

    .1PTH hormone.2Calcitonin

    : 1. 2. ) ( 3.4.D 5.

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    :1. , 2..3Trousseaus , Chvosteks signs

    4.

    ,, 5.

    6.

    ,7.

    8.

    ) :().(IV Calcium1. 2.

    _____________________________

    : .1Vit. D

    2.

    3.

    4.

    :1.)( 2. 3. Calcium 4.

    50%

    : 1. 2. 3.

    :1. - ) ( 2., ,3. 4.: 5.-6.

    :1. ) +(NaCl 0.9%2. 3. .4IM Calcitonin

    5.

    .6Mithrhtramycin

    7.

    8.

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    :1. 2. 3.4. 5.

    -- :1.51.51.51.5----2.5 meq/L2.5 meq/L2.5 meq/L2.5 meq/L

    >1.5

    :'

    : ),

    ) , ,

    :

    IVIVIVIV ( )

    2.5

    :- )OTCOTCOTCOTC (MaaloxMaaloxMaaloxMaalox

    :

    ' -

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    :

    IV CalciumIV CalciumIV CalciumIV Calcium

    :2.52.52.52.5----4.5 mg/4.5 mg/4.5 mg/4.5 mg/dLdLdLdL

    ATPATPATPATP - ) ) -

    :

    -

    : ) IVIVIVIV)IVIVIVIVPOPOPOPO

    :

    - : ,:,:

    ,,CSF :96-106meq/L

    :, ' :, ,:

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    10/1010

    : :, ,

    : ,- , , , -