Electrolytes replacement

If the patient is acutely ill or has vomiting and diarrhea, the nurse measures the fluid intake and output and observes the patient closely for signs of dehydration. If dehydration is apparent, the nurse notifies the primary health care provider. If the patient is or becomes dehydrated, oral or IV fluid and electrolyte replacement may be necessary. The nurse takes vital signs every 4 hours or as ordered by the primary health care provider. 

Whether a fluid or electrolyte imbalance occurs depends on the amount of fluid and electrolytes lost and the ability of the individual to replace them. For example, if a patient receiving a diuretic eats poorly and does not drink extra fluids, an electrolyte and water imbalance is likely to occur, especially during initial therapy with the drug. However, even when a patient drinks adequate amounts of fluid and eats a balanced diet, an electrolyte imbalance may still occur and require electrolyte replacement (see Chapter 58 and Display 58-2 for additional discussion of fluid and electrolyte imbalances). 

ANTIDIARRHEALS. The nurse notifies the primary health care provider if an elevation in temperature occurs or if severe abdominal pain or abdominal rigidity or distention occurs because this may indicate a complication of the disorder, such as infection or intestinal perforation. If diarrhea is severe, additional treatment measures, such as IV fluids and electrolyte replacement, may be necessary. 

Adjunctive therapy with fluid and electrolyte replacement should be initiated. Nutritional support with enteral or parenteral nutrition may be indicated for patients unable to eat for more than 5 to 7 days.2 Some evidence suggests that enteral nutrition provides anti-inflammatory effects in patients with active CD.40,41... 

Profuse or prolonged vomiting can lead to complications of dehydration and metabolic abnormalities. Patients must have adequate hydration and electrolyte replacement orally (if tolerated) or intravenously to prevent and correct these problems. Some pharmacologic treatments work locally in the GI tract (e.g., antacids and prokinetic agents), whereas others work in the central nervous system (e.g., antihistamines and antiemetics).1... 

The primary treatment of acute diarrhea includes fluid and electrolyte replacement, dietary modifications, and drug therapy. 

The goals of treatment for diarrhea are to relieve symptoms, maintain hydration, treat the underlying cause(s), and maintain nutrition. The primary treatment of acute diarrhea includes fluid and electrolyte replacement, dietary modifications, and drug therapy. 

Provide supportive care for patients with CNS infections, including hydration, electrolyte replacement, antipyretics, analgesics, and antiepileptic drugs. 

The only current treatment of EHEC infection is supportive, including fluid and electrolyte replacement, often in the form of ORT. Most illnesses resolve in 5 to 7 days. Patients should be monitored for the development of HUS. Antibiotics are currently contraindicated because they can induce the expression and release of toxin. Antimotility agents should be avoided because they may delay clearance of the pathogen and toxin. This, in turn, may increase the risk of systemic complications. 

For peritonitis, early and aggressive intravenous fluid resuscitation and electrolyte replacement therapy are essential. A common cause of early death is hypovolemic shock caused by inadequate intravascular volume expansion and tissue perfusion. 

Nephrotoxicity IDV potentially TDF Onset IDV—months after therapy TDF—weeks to months after therapy Symptoms IDV—asymptomatic rarely develop end-stage renal disease TDF—asymptomatic to symptoms of nephrogenic diabetes insipidus, Fanconi syndrome 1. History of renal disease 2. Concomitant use of nephrotoxic drugs Avoid use of other nephrotoxic drugs adequate hydration if on IDV monitor creatinine, urinalysis, serum potassium and phosphorus in patients at risk D/C offending agent, generally reversible supportive care electrolyte replacement as indicated... 

Fig. 4.3. Cyclic voltammogram for adsorbed tin on platinum, v = 10 mV/s. Experimental procedure 11 min. adsorption from a 4 x 10-4 M Sn(S04)2 solution in 0.5 M H2S04 at 0.5 V followed by electrolyte replacement with pure supporting electrolyte.

General supportive measures, including acetaminophen as an antipyretic (aspirin or other nonsteroidal antiinflammatory drugs may displace bound thyroid hormone), fluid and electrolyte replacement, sedatives, digoxin, antiarrhythmics, insulin, and antibiotics should be given as indicated. Plasmapheresis and peritoneal dialysis have been used to remove excess hormone in patients not responding to more conservative measures. 

The mainstay of treatment for cholera consists of fluid and electrolyte replacement with ORT to restore fluid and electrolyte losses. Rice-based rehydration formulations are the preferred ORT for cholera patients. In patients who cannot tolerate ORT, IV therapy with Ringer s lactate can be used. 

Fluid and electrolyte replacement should be initiated at the onset of diarrhea. 

Initial therapy of PMC should include discontinuation ofthe offending agent. The patient should be supported with fluid and electrolyte replacement. 

Most patients with enterocolitis require no therapeutic intervention. The most important part of therapy for Salmonella enterocolitis is fluid and electrolyte replacement. Antimotility drugs should be avoided because they increase the risk of mucosal invasion and complications. 

Oral fluid and electrolyte replacement is the cornerstone of treatment. Oral Lactobacillus therapy may reduce the duration of diarrhea and or viral excretion. There is no role for antibiotics. 

Treatment — Because of the severe dehydration caused by cholera infection, the most important therapy is fluid and electrolyte replacement. Many antibiotics are effective against V. cholerae, including tetracycline, doxycycline, ciprofloxacin, and erythromycin.3... 

Loperamide is an antidiarrhoeal drug indicated for use in adults and children over 12 years. Loperamide should not be administered in children under 4 years v/ho have diarrhoea. Children are more sensitive to the occurrence of the side-effect of respiratory depression. Fluid and electrolyte replacement are first-line treatments in diarrhoea. 

Plasma volume depletion Prolonged use of vasopressors may result in plasma volume depletion correct this by appropriate fluid and electrolyte replacement therapy. If plasma volumes are not corrected, hypotension may recur when these drugs are discontinued. 

Activated charcoal adsorbs salicylate effectively, and has been given in repeated oral doses (50 g 4 hourly) to enhance clearance, although its effect on outcome is unknown. Fluid and electrolyte replacement are important and special care should be taken to maintain normal potassium concentrations. Patients with signs of poisoning, especially when plasma salicylate concentration exceeds 500 mg/1, should receive specitic elimination therapy. 

Antidiarrhoeals are given for symptomatic relief of diarrhoea. The first step in treatment of acute diarrhoea is replacement of fluid and electrolytes. If due to diarrhoea there is severe dehydration, it requires immediate hospitalization for IV fluid and electrolyte replacement. Antidiarrhoeal drugs are administered for obtaining symptomatic relief in acute diarrhoea but have untoward effects. Alongwith antidiarrhoeal drugs, antispasmodics are administered in those patients who have diarrhoea with abdominal pain. 

Other costs such as site preparation, engineering, legal, electrolyte replacement, etc. are included. 

Usually symptomatic management with fluids and electrolyte replacement... 

There are circumstances when some electrolyte replacement is necessary, for example during repeated bouts of strenuous exercise... 

The treatment for VHP infection is mainly supportive, including intravenous fluids and electrolyte replacement. Hemodialysis, invasive monitoring, and vasopressor therapy may also be needed. Care should be taken... 

Electrolytic replacement of vinylic bromine by hydrogen in ( )-bromostilbene is complicated by the formation of difriienylacetylene in addition to trans- and a small amount of cif-stilbene. °... 

Costill, D- L Cote, R., Miller, 1 ., Miller, T., and Wyndcr, 5. (1975). Water and electrolyte replacement during repeated days of work in the heat. Atfiaf. Space Environ. Med. 46, 795-800. 

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