Normal saline .9. & glucose & ringer lactate

Normal saline .9. & glucose & ringer
lactate
..
#ﻃﻴﺐ .. ﻋﻠﻰ ﺍﻯ ﺍﺳﺎﺱ ﺍﻧﺎ ﺑﺨﺘﺎﺭ ﺍﻟﻤﺤﻠﻮﻝ
ﻟﻠﻤﺮﻳﺾ ﺑﺘﺎﻋﻰ ؟؟
..
#ﺍﻭﻻ .. ﺗﻌﺎﻟﻮ ﻧﻌﺮﻑ ﺍﻟﻔﺮﻕ ﺑﻴﻦ ﻣﺤﻠﻮﻝ
ﺍﻟﺠﻠﻮﻛﻮﺯ ﻭﺍﻟﺮﻳﻨﺠﺮ
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#ﺍﻭﻝ ﺣﺎﺟﻪ ﻻﺯﻡ ﻧﻌﺮﻓﻬﺎ .. ﺍﻥ ﻣﺤﻠﻮﻝ ﺍﻟﺮﻳﻨﺠﺮ
ﻻﻛﺘﻴﺖ ﻣﺶ ﺑﻴﻘﺪﺭ ﻳﺪﺧﻞ ﺩﺍﺧﻞ ﺍﻟﺨﻼﻳﺎ ..
ﻳﻌﻨﻰ ﺑﻴﺘﻮﺯﻉ ﺑﺲ ﻋﻠﻰ ﺍﻟﺪﻡ ﻭﺑﻴﻦ ﺍﻟﺨﻼﻳﺎ
ﻭﻛﺪﻩ ﺗﺮﻛﻴﺰﻩ ﻓﻰ ﺍﻟﺪﻡ ﻫﻴﺰﻳﺪ
.
#ﺍﻣﺎ .. ﻣﺤﻠﻮﻝ ﺍﻟﺠﻠﻮﻛﻮﺯ ﻳﺨﺘﻠﻒ ﻋﻨﻪ ﺍﻧﻪ
ﺑﻴﺪﺧﻞ ﺩﺍﺧﻞ ﺍﻟﺨﻼﻳﺎ ﻭﻛﺪﻩ ﻫﻴﺘﻮﺯﻉ ﻋﻠﻰ 3
ﺍﻣﺎﻛﻦ ﺑﻴﻦ ﺍﻟﺨﻼﻳﺎ ﻭﻓﻰ ﺍﻟﺪﻡ ﻭﺩﺍﺧﻞ ﺍﻟﺨﻼﻳﺎ
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#ﻳﻌﻨﻰ .. ﺍﻓﻬﻢ ﻣﻦ ﻛﺪﻩ ﺍﻧﻪ ﻣﺤﻠﻮﻝ ﺍﻟﺮﻳﻨﺠﺮ
ﻛﻤﻴﺘﻪ ﻓﻰ ﺍﻟﺪﻡ ﻫﺘﻜﻮﻥ ﺍﻛﺒﺮ ﻣﻦ ﻣﺤﻠﻮﻝ
ﺍﻟﺠﻠﻮﻛﻮﺯ
___________________
* # ﺍﻟﺴﺆﺍﻝ ﺑﻘﻰ .. ﻟﻮ ﺟﺎﻟﻨﺎ ﻣﺮﻳﺾ ﻓﻰ
ﺍﻟﺼﻴﺪﻟﻴﻪ ﺑﻨﺰﻳﻒ ﺷﺪﻳﺪ ﻭﻓﻘﺪ ﻛﻤﻴﺔ ﺩﻡ
ﻛﺒﻴﺮﻩ ﻫﺪﻳﻠﻪ ﺟﻠﻮﻛﻮﺯ ﻭﻻ ﺭﻳﻨﺠﺮ ؟؟
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- ﻃﺒﻌﺎ ﺭﻳﻨﺠﺮ ﻟﺴﺒﺐ ﺍﻟﻠﻰ ﻗﻮﻟﻨﺎ ﺍﻧﻪ ﺭﻳﻨﺠﺮ
ﺗﺮﻛﻴﺰﻩ ﻓﻰ ﺍﻟﺪﻡ ﺍﻋﻠﻰ ﻭﻛﻤﺎﻥ ﻫﻴﻌﻮﺽ
ﻛﻤﻴﺔ ELECTROLYTE ﺍﻟﻠﻰ ﻓﻘﺪﺕ .. ﻭﺩﻩ
#ﺃﻭﻝ ﺍﺧﺘﻼﻑ
..
# ﺗﺎﻧﻰ .. ﺣﺎﺟﻪ
ﻟﻮ ﻣﺮﻳﺾ ﻋﻨﺪﻩ Sever vomiting and
diarrhea
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ﻫﺪﻳﻠﻪ ﺭﻳﻨﺠﺮ ﻻﻛﺘﻴﺖ ﻭﻟﻴﺲ ﻣﺤﻠﻮﻝ ﺟﻠﻮﻛﻮﺯ
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ﻫﻮ ﻣﺶ ﺍﻟﻤﻔﺮﻭﺽ ﺍﻧﻪ ﺭﻳﻨﺠﺮ ﻻﻛﺘﻴﺖ ﺩﻩ
ﺣﻤﻀﻰ ﻭﺍﻟﺤﺎﻟﻪ ﺍﻟﻠﻰ ﻣﻌﺎﻧﺎ ﻓﻘﺪﺕ ﻛﻤﻴﻪ ﻣﻦ
.. electrolyte ﻳﻌﻨﻰ ﺍﻟﻤﻔﺮﻭﺽ ﺍﺩﻱ ﺍﻟﻤﺮﻳﺾ
ﺣﺎﺟﻪ ﻗﻠﻮﻳﻪ ﻋﻠﺸﺎﻥ ﺗﻌﻮﺽ ﺍﻟﻠﻰ ﻓﻘﺪ ...
ﻳﻌﻨﻰ ﻣﻔﺮﻭﺽ ﺍﻟﺮﻳﻨﺠﺮ ﻣﻴﻨﻔﻌﺶ
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#ﻗﺎﻟﻚ .. ﻻ ﺍﺻﻼ ﺍﻟﺮﻳﻨﺠﺮ ﺑﻴﺤﺼﻠﻪ
metabolism ﻭﺑﻴﺪﻯ bicarbonate ﺑﺘﻌﺎﺩﻝ
ﺍﻟﺤﻤﻀﻴﻪ .. ﻭﺑﺘﻌﻮﺩ ﻛﻤﻴﻪ ﺍﻻﻟﻜﺘﺮﻭﻟﻴﺖ ﺍﻟﻠﻰ
ﻓﻘﺪﺕ
ﻭﺍﻫﻢ ﺣﺎﺟﻪ ﻓﻰ electrolyte ﻫﻮ Na
.
ﻭﻃﺒﻌﺎ ﻛﻠﻨﺎ ﻋﺎﺭﻓﻴﻦ ﺍﻥ ﺍﻟﺼﻮﺩﻳﻮﻡ ﺑﻴﺘﺂﺧﺪ
ﻣﻌﺎﻩ ﻣﻴﻪ ﻳﻌﻨﻰ ﻫﻴﻌﺎﻟﺞ ﺍﻟﺠﻔﺎﻑ ﻛﻮﻳﺲ ﺧﺎﻟﺺ
.. ﻭﻛﻤﺎﻥ ﺑﻴﺴﺘﺨﺪﻡ ﻓﻰ ﺣﺎﻟﻪ
hyponatrimia
....
#ﺍﻣﺎ .. ﺍﻟﺠﻠﻮﻛﻮﺯ ﺑﻘﻰ .. ﻓﺪﻯ ﺑﻴﺤﺼﻠﻪ
Metabolism
ﺍﻟﻰ CO2 & WATER
ﻭﻃﺒﻌﺎ ﺍﻟﻤﻴﻪ ﻣﻦ ﺍﻟﺴﻬﻞ ﺑﺘﺪﺧﻞ ﺩﺍﺧﻞ ﺍﻟﺨﻠﻴﻪ
ﻭﺗﺴﺤﺐ ﻣﻌﺎﻫﺎ Na
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ﻳﻌﻨﻰ ﻟﻮ ﺍﺳﺘﺨﺪﻣﺘﻪ ﻓﻰ ﺣﺎﻟﻪ ﺍﻟﺠﻔﺎﻑ ﻫﻴﺰﻳﺪ
ﺍﻟﺠﻔﺎﻑ
#ﺑﺲ .. ﻣﻤﻜﻦ ﺍﺳﺘﺨﺪﻣﻪ ﻓﻰ ﻋﻼﺝ
hypernatremia ﻭﻋﺮﻓﻨﺎ ﻟﻴﻪ .
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* #ﻃﻴﺐ .. ﻟﻮ ﻣﺮﻳﺾ APPENDICITITES
‏( ﻣﺮﻳﺾ ﻋﻨﺪﻩ ﺍﻟﺰﺍﻳﺪﻩ ‏) .. ﻫﻨﺪﻳﻠﻪ ﺍﻳﻪ ؟؟؟
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ﻫﻨﺪﻳﻠﻪ ﺟﻠﻮﻛﻮﺯ ﻻﻧﻪ ﻏﺎﻟﺒﺎ ﺑﻴﻜﻮﻥ ﻣﺶ
ﻗﺎﺩﺭ ﻳﺂﻛﻞ ﻭﻛﺪﻩ .. ﻓﺒﻨﺪﻳﻠﻪ ﺣﺎﺟﻪ ﺗﻌﻮﺿﻪ
ﻛﺪﻩ .. ﻭﻧﻔﺲ ﺍﻟﻤﻮﺿﻮﻉ ﺑﻌﺪ ﺍﻟﻌﻤﻠﻴﺎﺕ
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* #ﻃﻴﺐ .. ﻟﻮ ﻣﺮﻳﺾ ﻛﺒﺪ ﺍﺩﻳﻠﻮ ﺍﻯ ﻧﻮﻉ ﻣﻦ
ﺍﻟﻤﺤﺎﻟﻴﻞ ؟؟؟
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- ﻃﺒﻌﺎ ﻫﻨﺪﻳﻠﻪ ﺍﻟﺠﻠﻮﻛﻮﺯ .. ﻋﻠﺸﺎﻥ ﻣﺮﻳﺾ
ﺍﻟﻜﺒﺪ ﺑﻴﻜﻮﻥ ﺑﻴﻌﺎﻧﻰ ﻣﻦ Na and water
retention
ﻓﻤﺎ ﻳﻨﻔﻌﺶ ﺍﺩﻳﻠﻪ ﺭﻳﻨﺠﺮ ﻭﻻ ﻣﺤﻠﻮﻝ ﻣﻠﺢ
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# ﺧﻠﻰ ﺑﺎﻟﻚ ...
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* # ﻟﻮ ﻣﺮﻳﺾ ﺳﻜﺮ ﻋﺎﻟﻰ ﻃﺒﻌﺎ ﻫﻨﺪﻳﻠﻪ
ﻣﺤﻠﻮﻝ ﻣﻠﺢ
* #ﻭﻟﻮ ﻣﺮﻳﺾ ﺿﻐﻂ ﻋﺎﻟﻰ ﺍﺩﻳﻠﻪ ﺟﻠﻮﻛﻮﺯ
* #ﻭﻟﻮ .. ﻋﺎﻳﺰ ﺍﺳﺘﺨﺪﻡ ﻣﺤﻠﻮﻝ ﺍﻟﺠﻠﻮﻛﻮﺯ
ﻛﻤﺬﻳﺐ ﻟﺒﻌﺾ ﺍﻟﺤﻘﻦ ﺍﺳﺘﺨﺪﻡ ﺍﻗﻞ ﺗﺮﻛﻴﺰ
__________________
#ﺁﺧﺮ _ ﺣﺎﺟﻪ_ ﺑﻘﻰ .. ﺑﺲ ﻣﻌﻠﻮﻣﻪ ﻣﻬﻤﻪ ﺟﺪﺍﺍﺍ
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ﻣﻴﻨﻔﻌﺶ ﺍﺧﻠﻂ ﺳﻴﻔﺘﺮﺍﻳﻜﺴﻮﻥ ﻣﻊ ﻣﺤﻠﻮﻝ
ﺭﻳﻨﺠﺮ ﻟﺒﻴﺒﻰ ﻋﻤﺮﻭ ﺷﻬﺮ
ﻋﻠﺸﺎﻥ ﺭﻳﻨﺠﺮ ﺑﻴﺤﺘﻮﻯ ﻋﻠﻰ ﻛﺎﻟﺴﻴﻮﻡ ..
ﻟﻮ ﺍﺗﺨﻠﻂ ﻣﻊ ﺍﻟﺮﻳﻨﺠﺮ ﻫﻴﺘﺮﻳﺐ ﻋﻠﻰ lung ..
ﻭﻳﺆﺩﻯ ﺍﻟﻰ death ﻻ ﻗﺪﺭ ﺍﻟﻠﻪ
..
#ﻭﻣﻴﻨﻔﻌﺶ .. ﺧﺎﻟﺺ ﺍﺳﺘﺨﺪﻡ ﻣﺤﻠﻮﻝ
ﺍﻟﺠﻠﻮﻛﻮﺯ ﻟﻤﺮﻳﺾ ﻋﻨﺪﻩ intracranial
<< pressure ﻋﻠﺸﺎﻥ ﺍﻟﺠﻠﻮﻛﻮﺯ ﺑﻴﺪﺧﻞ
ﺍﻟﺨﻼﻳﺎ ﻭﺍﻟﺨﻼﻳﺎ ﻭﺣﺪﻫﺎ ﺿﻐﻄﻬﺎ ﻋﺎﻟﻰ .. ﻓﻠﻮ
ﺍﺳﺘﺨﺪﻣﺖ ﺍﻟﺠﻠﻮﻛﻮﺯ ﻣﻤﻜﻦ ﺍﻟﺨﻼﻳﺎ ﺗﻔﺮﻗﻊ
..
- ﻭﻃﺒﻌﺎ ﻣﺤﻠﻮﻝ ﺍﻟﻤﻠﺢ ﺯﻯ ﺍﻟﺮﻳﻨﺠﺮ ﺑﺲ
ﺍﻻﺧﺘﻼﻑ
ﺍﻧﻪ ﻟﻮ ﻣﺮﻳﺾ ﺳﻜﺮ ﻋﺎﻟﻰ ﺑﺴﺘﺨﺪﻡ ﻣﺤﻠﻮﻝ
ﺍﻟﻤﻠﺢ ﻋﻠﺸﺎﻥ lactic acidoses