GU—IntrototheGUSystemandEvaluationofElectrolyte：顾介绍顾体系和评价电解质

GU—Intro to the GU System and Evaluation of Electrolyte and Acid-Base Disorders The kidney is the pr

GU—IntrototheGUSystemandEvaluationofElectrolyteandAcid-Base Disorders kidney Theisthepri__ryregulatoroffluidandelectrolytes.Alsoregulates acid-basebalan__.Itperformsthisthroughselectivelyretainingandexcreting__rtain components.Bodyhomeostasisis__intainedthroughnor__lkidneyfunctions Renaldiseases usuallyconsistofseveralelementsthatreflectunderlying pathologyanddurationofdisease: 1) Disturban__sinurinevolume –oliguria,polyuria,andanuria 2) Abnor__lityinurinesediment –casts,glucose 3) Abnor__lproteinexcretion –nor__llynoproteinpassesintotheurine 4) Reductioninglomerularfiltrationrate –azotemiaoruremia 5) Presen__ofHTNand/orede__ 6) Electrolyteabnor__lities ICFandECF. Totalbodywaterisdistributedinto2__jorcompartments:the ICF composes2/3ofbodywater.The__jorparticlesintheICFarepotassium,organic ECF phosphate(ATP),and__gnesium.composes1/3oftotalbodywater.Itdivides intotheinterstitialfluidandintr__ascularvolume.The__jorECFparticlesaresodium, chloride,andbicarbonate. SerumO__olality Serumo__olality isthesoluteorparticlecon__ntrationoffluid.ICFandECF h__eequalo__olality.Theformulaforserumo__olalityis: + Serumo__olality=2Na+glucose+BUN 18 2.8 275-290mo__ol/kg. Thenor__lpla__ao__olalityisSodiumisthemost importantfactorforo__olality. thirst Thepri__rystimulusforwateringestionisdueto1)increasedo__olality2) decreaseinECF,whichwillleadtoadecreaseinICF.Inapatientthatisdehydrated,we and needtogivealdosteronebecauseitwillbalan__outthewaterelectrolytelevels.The patientwillre__iveadequatesodiumandwater.ADHisineffectivebecauseitwillonly increasewaterandnotcorrectelectrolyteproblems. hypertonicityofbloodvessels Thepri__rystimulusforwatersecretionis.ICF waterissecretedintothevessels(ECF)tobalan__outthewater. VolumeDepletion-SignsandSymptoms 1) Hypotension 2) Orthostasis 3) Tachycardia 4) Drymucusmembranes 5) Oliguriaandlackoftears