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isotonic contraction: 0.9 nacl

na and h20 loss

SE: pulmonary edema (if too fast)

Hypertonic contraction: 11% nacl

5% dextrose

loss of h20

Hypotonic contraction: 3% nacl

loss of na (concentration should be about 130)

SE: monitor for fluid overload

resp acidosis (hypoventilation): sodium bicarb (severe)

with oxygen and ventilation

resp alkalosis (hpervenilation): co2 rebreath

sedative can be used

metabolic alkalosis: NAcl and Kcl

due to: Gastric loss, sodium bicard excess, hypoventilation, incrased renal excretion of bicarb, accumulation of organic acids

metabolic acidosis: sodium bicarb

due to: Chronic renal failure, diarrheam lactic acidosis, ketoacidosis, aspirin and methanol poisoning

Caution: infuse careful rapid conversion dangerous

Hypokalemia (< 3.5): Kcl, kdur, micro k

SE: PO: GI irritation(especially not sustained release) rare: hyperkalema
IV:Hyperkalemia, renal failure, ECG changes

Hyperkalemia (>5): stop diet K and K sparing drugs, suport cardiac troubles, use glucose and insulin infusion, correct acidosis with sodiumbicarb

at 8-9: cardaic arrest and death

hypomagnesemia ( < 1.3): IV magnesium (frank)

milk of magnesia

causes: Diarrhea, hemodialysis, kidney dz, prolonved Iv feed


SE: Neuromuscular blockade, resp paralysis,
***calcium gluconate
Hypermagnesemia: AV block

Hypermagnesemia (> 2.1): Calcium gluconate

cause: : renal isufficiency, hypotension, sedation, ecg changes


Resp paralysis at 12-15
Cardiac arrest at 25

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