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127 Cards in this Set
- Front
- Back
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Name 4 components of body fluid
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water, fluid compartments, electrolytes, blood
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The human body is made up of how much water?
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45%-75%
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List 5 physiologic transport mechanisms for distributing fluid
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osmosis
filtration, passive diffusion facilitated diffusion active transport |
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What is osmosis?
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osmosis helps regulate the distribution of water by controlling the movement of fluid from one location to another
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What is Filtration?
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filtration regulates the movement of water and substances from a compartment where the pressure is HIGHER to one where the pressure is LOWER.
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What is the force of filtration known as?
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hydrostatic pressure
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What is passive diffusion?
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the physiologic process in which dissolved substances, such as electrolytes and gases, move from an area of HIGHER concentration to an area of LOWER concentration through a semi-permeable membrane (occurs without energy)
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What does passive diffusion facilitate?
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electrochemical neutrality = an identical balance of cations with anions
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What is facilitated diffusion?
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facilitated diffusion is the process in which certain dissolved substances require the assistance of a carrier molecule to pass from one side of a semipermeable membrane to another
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What is active transport?
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active transport, a process of chemical distribution that requires energy (ATP)
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Name an example of active transport.
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sodium-potassium pump system which regulates the movement of potassium from LOWER concentrations in the extracellular fluid into cells where it is more highly concentrated
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Name 10 examples of assessments that provide data about a client's fluid status
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weight, bp, temp, pulse, resp,
urine, stool, skin, eyes, lungs, breathing, energy, cognition, consciousness |
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List 3 methods for maintaining and restoring fluid volume
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treating the cause of hypovolemmia,
increasing oral intake, administering IV fluid replacements, controlling fluid losses |
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What is hypovolemia?
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hypovolemia refers to a low volume of extracellular fluid which can result in dehydration if left untreated
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List 4 methods for reducing fluid volume
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treating the disorder, restricting fluid intake,
reducing salt consumption, administering diuretic drugs to promote urination, d/c IV fluid infusions |
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What is hypervolemia?
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hypervolemia refers to a higher than normal volume of water in the intravascular fluid compartment, this can lead to edema
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List 6 reasons for administering IV fluids
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maintain/restore fluid balance,
maintain/restore electrolytes, administer water soluble vitamins, provide source of calories, administer drugs, replace blood and blood products |
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What is a crystalloid solution?
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a solution that is classified as either isotonic (same), hypotonic (contains fewer substances than plasma, will burst), or hypertonic (contains more substances than plasma, will shrink) depending on the concentration of dissolved substances in relation to plasma
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What is a colloid solution?
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a solution used to replace circulating blood volume because the molecules pull fluid from other compartments
ex: blood, blood products, plasma expanders |
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List the 4 factors that influence the type of tubing used during IV administration.
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distance,
volume to be administered, type of container the solution is packaged, the necessary rate at which the IV diffuses determines the appropriate drop size |
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When would a filter be necessary for use during an IV administration?
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filtered tubing is generally used when administering nutrition, client is high risk for infection, pediatric clients, or administering blood and packed cells
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Describe gravity infusion.
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the height of the IV solution is more important during this method than the type of tubing and is used to overcome the pressure within the clients vein. Elevate solution 18-24 inches about the site of the infusion.
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Describe the purpose of using an electronic infusion device.
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An infusion pump uses pressure to infuse solutions. A volumetric controller instills IV solutions using gravity.
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What is venipuncture?
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is the process in which one accesses the venous system by piercing a vein with a needle.
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List 5 criteria when selecting a vein to administer an IV fluid.
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-use veins on nondominant side,
-do not use foot and leg veins, -do not use vein on side of previous breast surgery or in which vascular surgery has been performed for dialysis, -choose vein in a location uneffected by joint movement, avoid using veins on inner side of wrist, -feel/look for a fairly straight vein, never use a vein that looks inflammed or skin looks impaired |
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List 7 complications associated with IV fluid administration
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-circulatory overload,
-infiltration, -phlebitis, -thrombus formation, -pulmonary embolus, -air embolism |
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Discuss 2 purposes for inserting an intermittent venous access device.
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-the patient no longer needs continuous infusions of fluid,
-needs intermittent administrations of IV medication, -may need emergency IV fluid or medications if condition deteriorates |
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Name 5 types of transfusion reactions
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usually occur within 5-15 minutes of transfusion and can include incompatibility,
-febrile, -septic, -allergic, -moderate chilling, -overload, -hypocalcimia |
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A nurse is initiating a peripheral venous access IV infusion ordered for a patient presurgically. In what position would the nurse place the patient to perform this skill?
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low fowler's
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A physician orders an infusion of 250 mL of NS in 100 minutes. The set is 20 gtt/mL. What is the flow rate?
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50 gtt/min
The flow rate (gtt/min) equals the volume (mL) times the drop factor (gtt/mL) divided by the time in minutes. |
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Which of the following commonly used intravenous solutions is hypotonic?
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5% dextrose in 0.45% NaCl is hypotonic.
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Name the 3 primary extracellular electrolytes.
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-sodium,
-chloride, -bicarbonate |
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When providing care for a patient who has a peripheral intravenous catheter in situ (lumens with no infusions), the nurse should:
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change the site every 3-4 days
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A nurse assessing the IV site of a patient observes swelling and pallor around the site and notes a significant decrease in the flow rate. The patient complains of coldness around the infusion site. What IV complication does this describe?
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Infiltration is the escape of fluid into the subcutaneous tissue due to a dislodged needle that has penetrated a vessel wall. Signs and symptoms include swelling, pallor, coldness, or pain around the infusion site and significant decrease in the flow rate. The signs of sepsis include red and tender insertion site, fever, malaise, and other vital sign changes. The symptoms of thrombus are local, acute tenderness; redness, warmth, and slight edema of the vein above the insertion site. The signs of speed shock are pounding headache, fainting, rapid pulse rate, apprehension, chills, back pains, and dyspnea.
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The higher the solution, the ________ the rate of infusion.
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– faster
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A patient who is NPO prior to surgery is complaining of thirst. What is the physiologic process that drives the thirst factor?
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Decreased blood volume and intracellular dehydration
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If you have 4oz of frozen ice chips, how much liquid would you document?
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1/2 of frozen = liquid
answer: 2oz |
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What is the purpose of administering plasma expanders?
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to increase the blood volume and raise the blood pressure
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A nurse monitoring the intake and output of fluids for a patient with severe diarrhea knows that normally how many mL of body fluids is lost via the gastrointestinal tract?
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300 ml
Generally, fluid intake averages 2,600 mL per day, with approximately -1,300 mL coming from ingested water, -1,000 mL coming from ingested food, -and 300 mL from metabolic oxidation. |
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A nurse is caring for a client who is to be provided nutrition intravenously for a short duration following a tracheostomy. Which of the following intravenous solutions needs to be administered to this client?
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-Crystalloid solutions are to be administered to the client. The crystalloid solutions can be classified as isotonic, hypotonic, and hypertonic.
Isotonic solutions are generally administered to maintain fluid balance in clients who may not be able to eat or drink for a short period. -Lipid emulsions are administered when the client is severely malnourished and may not be able to consume food for a long period. In this case, lipid emulsion is not necessary because the client will not be able to take food for a short period. In addition, there is a risk of adverse reaction in clients while administering lipid emulsion. -Colloid solutions are used to replace circulating blood volume because the suspended molecules pull fluid from other compartments. -Plasma expanders are used as economical and virus-free substitutes for blood and blood products when treating hypovolemic shock. |
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The nurse is administering albumin to a patient to promote movement of fluid into the capillaries. What is the "pulling force" of fluid by use of a protein such as albumin known as?
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-Plasma proteins, particularly albumin, concentrated in the intravascular space or plasma facilitate the reabsorption of fluid into the capillaries by the action of colloid osmotic pressure.
-**Diffusion** is the movement of a solute from an area of higher concentration to an area of lower concentration. -Osmosis is the movement of water from an area of lesser solute concentration and more water to an area of greater solute concentration and less water until equilibrium is achieved. -Active transport is a process that requires energy for the movement of substances through a cell membrane from an area of lesser solute concentration to an area of higher solute concentration. |
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When the nurse is starting an intravenous infusion on a client who will be receiving multiple intravenous antibiotics, which of the following guidelines should the nurse follow?
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Use larger veins and the distal portion of the vein, leaving the more proximal sites for later venipunctures.
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A nurse is choosing a vein to start an IV infusion in a patient. Which of the following are recommended veins to use when initiating an IV infusion? Select all that apply.
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• Cephalic vein
• Metacarpal • Basilic veins • Superficial veins on the dorsal aspect of the hand |
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A nurse uses an infusion pump to administer the IV solution to a client. The nurse is aware that an infusion pump adjusts the pressure according to the resistance it meets and there is a possibility that the needle may get displaced. How would a change in the needle's position affect the infusion pump?
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The nurse should be aware that an infusion pump continues to infuse fluid even when the needle is displaced. The pump continues to infuse fluid into the tissue until the machine's maximum preset pressure reaches its limit. The infusion pump adjusts the pressure according to the resistance it meets. The pump does not compress the tubing to infuse the solution at a precise, preset rate, which is done by a volumetric controller. An electronic infusion device would sound an audible alarm if the infusion container is empty, air is detected in the tubing, or resistance is met in delivering the fluid. The infusion pump does not stop pushing the fluid in the client's vein when the needle becomes displaced.
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A patient asks a nurse if it is possible to contract a disease by donating blood. How would the nurse respond?
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There is no way you can receive a disease by GIVING blood.
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Which of the following statements accurately describes a guideline when using a venous access?
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The system is accessed with a noncoring needle, and patency is maintained by periodic flushing. When venous access is desired, the location of the injection port must be palpated. In general, a ¾-inch, 20-gauge needle is most frequently used. A larger gauge (19-gauge) is preferred for administration of blood products.
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A nurse reads the laboratory report for a patient and notes that the patient has hyponatremia. What physical assessment would be made?
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Hyponatremia is an ECF sodium deficit, resulting in osmotic pressure changes as ECF moves into the cells. When this occurs, prints from the examiner's fingers tend to remain on the patient's skin over the sternum when pressure is applied with the fingers.
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A client has been admitted to the health agency with symptoms of malnutrition. The nurse needs to administer a solution of nutrients to meet the caloric and nutritional needs of the client. The nutrient solution is packaged in a glass container and needs to be administered at a rate of 60 drops/mL. What type of tubing should the nurse use in this case?
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The nurse should use filtered tubing to administer the nutrient to the client with symptoms of malnourishment.
If unvented tubing is inserted into a glass bottle, the nutrient solution will not leave the glass container. Filtered tubing is generally used to administer parenteral solutions. Primary tubing is used when the tubing must span the distance from a solution that hangs several feet above the infusion site. Macrodrip tubing delivers a standard volume of up to 30 drops/mL, which is again not appropriate for the case. |
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A nursing instructor is preparing a class presentation for a group of nursing students on fluid balance and developmental considerations. Which of the following would the instructor most likely include when describing newborns and infants? Select all that apply.
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Infants have a proportionately larger percentage of total body weight as water (70% to 80%) than do adults (60%). A greater amount of the fluid is contained within the ECF compartment in infants than within that of adults. Because infants also have a greater surface area in relation to weight, they can lose a proportionately larger volume of fluid through the skin. Fluid requirements vary according to age, as do normal urine outputs. The infant’s kidneys are immature and lack the ability to concentrate urine fully. Metabolic and respiratory rates are high in infants, contributing to increased insensible fluid loss. Fluid loss can occur very rapidly in this age group.
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The passageways of the kidney permit the urine to flow to the bladder and....
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When a hypertonic solution is infused, it raises serum osmolarity, pulling fluid from the cells and the interstitial tissues into the vascular space. Examples of hypertonic solutions include 3% (NaCl) and 5% saline (NaCl).
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(see full question)
Based on knowledge of total body fluids, a nurse is especially watchful for a fluid volume deficit in an infant. Why would the nurse do this? |
An infant has considerably more total body fluid and ECF than an adult does. Because ECF is more easily lost from the body than ICF, infants are more prone to fluid volume deficits.
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During a blood transfusion of a client, the nurse observes the appearance of rash and flushing in the client, although the vital signs are stable. Which of the following interventions should the nurse perform for this client?
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The nurse should prepare to give an antihistamine because these signs and symptoms are indicative of an allergic reaction to the transfusion. The nurse needs to stop the transfusion immediately, infuse saline at a rapid rate, and administer oxygen if the client shows signs of incompatibility.
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INSIDE
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Water is the primary body fluid.
Most of water 25 L is found ... cells. 15 L outside cells |
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FASTER FASTER
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Water content varies with age, sex, adipose tissue. Infants have ... metabolism. They loose fluid ... than adults. They breath faster.
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________
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Elder people have decreased sense of thirst and kidneys are less sensitive to pH. Elder people have more heart and kidney disease , have more polypharmacy - risk for electrolytes imbalance.
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INFANT
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All those factors contribute for infants and elderly to be at greater risk for DEHYDRATION. But the ____ is at greater risk then elder because they are smaller, they don't have reserves of water and they cant maintain their homeostasis
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HIGHER, REQUIRE
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Gender also play role. FAT cells contain very LITTLE water, muscle tissue contain ______ amount of water. Women have more fat then men so men have more water in their body and they _____ more water.
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ELECTROLYTES/INCREASE
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Exercise will cause sweat and loos of water but also loos of ____ - signs: fatigue, weak, hd, nausea
Stress cause _____ in metabolism and increase adh - antiduretic hormone |
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pH
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When you alter your breathing you will alter you _____ balance
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urea, sugar
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Water contains solutes
•electrolytes •non electrolytes - ______ |
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SPACING, SECOND, EDEMA,
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Water distribution
_____- normal distribution of water, in and out ____ SPACING- abnormal accumulation of interstitial fluid _____ THIRD SPACING- abnormal accumulation of fluid where the should not be fluid ex. abdomen ASITIS. The fluid came from your cells, and vessels- so patient will be in imbalance |
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ASITIS
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______ abdomen ,patient may have difficulty breathing,
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intracellular
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_____ fluid Within the cells
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extracellular
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______ fluid
-Interstitial: surrounds cells -Intravascular: plasma. |
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Transcellular
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fluid in:
•CSF •GI fluids •lymph •joints •eye |
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SKELETAL/OBESE/ELDER
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_____ muscle will hold MORE water then Fat cell.
_____ clients may have only 45% weight as water. _____ will have lower proportion of water - less muscle mass. |
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Salute/Solvent
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Movement of Fluids and Electrolytes _____ - substance or particle that is DISSOLVED is solution. _____ - liquid or gas that CONTAINs the salutes
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filtration/HIGH/LOW
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Movement of Fluids and Electrolytes
_____ ex:When you make coffee in coffee maker. WATER & small Particles from _____ pressure to _____ pressure |
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osmosis
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Movement of Fluids and Electrolytes. _____ - WATER moves from LOW concentration of particles to HIGH concentration of particles.
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osmosis
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Movement of Fluids and Electrolytes. Imagine you have container divided with permeable membrane. In one side I put bunch of particles and less in the other side. I put equal amount of water on both sides. Water will be pulled from the side with LESSER amount of particles to the side with HIGH particle density. It will result in different amount of WATER in both sides of container.
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Diffusion
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Movement of Fluids and Electrolytes. _____ - PARTICLES move from the area of HIGH concentration to area with LOW concentration. ex:Glass of ice tea, you put sugar there. Sugar will sit at the bottom and there will be concentrated amount of sugar down there at the bottom. BUT eventually sugar will melt down and disperse (spread over) its self throughout the whole glass of ice tea. So it will go from area with HIGH concentration of particles to LOW concentration.
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DIFFUSION
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Alveolus sac (air sac) is lined by single cells and its next to vessel which is also thin. This will allows oxygen and carbon dioxide to exchange between areas of HIGHER concentration to LOWER concentration. This is _____.
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Active/GRADIENT
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_____ transport. Salutes (little molecules or ions) move from area of LESSER concentration to area of HIGH concentration across the _____ that will require ATP (Energy). It take CALORIES.
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_____
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Filtration: Water & Small Particles from High to Low Pressure DJM
Osmosis: Water From Low to High Diffusion: Particles From High to Low |
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2 to 2.5
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Fluid Intake
Primarily through drinking fluids recommended _____ L of fluid a day. |
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ENTERNAL
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We can take fluid orally or through tubes - this would be consider _____ Food liquid that enters our stomach like NGTs tubes or peg tube (through a abdominal wall, it's anchored by a surgeon) will consider ENTERNAL FEEDING.
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PARENTERAL
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_____ is used of needle, through the skin. IV fluids into vessel. Will replace electrolyte fluids, or replace nutrition. If IV has a lot of sugar in it it will have to go to a BIGGER vessel because the sugar may be devastating to the vessel -scratches the inside of the vessel.
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27/35
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IOM recommendation:___00 mL/day women, ___00 mL/day men
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80/20
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fluid comes
≈___% of fluid will come from H₂O ≈___% of fluid will come from food/metabolism of food |
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Sensible/Insensible
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Fluid Output
≈___:measurable Sensible loss is the stuff that we MEASURE Urine:≈500 mL/day ≈___:not measurable Skin:perspiration (≈600 mL/day) Lungs:exhalation (≈300 mL/day) Feces:≈100-200 mL/day |
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LARGER
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INFANT has ___ body proportion of weigh of water then the ADULT has. ADULT has more then ELDER people have. Muscle weights more then fat. Elder people lose muscle and replace it with fat. Infant are more SUSCEPTIBLE to water lost - they can get imbalance very quick
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HIGH/more/CONCENTRATED/PULLED
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Hormonal Regulation -
Antidiuretic hormone (ADH) - its released when hypothalamus senses a ___ serum osmolarity (there is a lot of PARTICLES in the water of your body). Too many particles- body wants ___ water. Antiduretic- you will hold the water. This will Restore blood volume by DECREASE diuresis & INCREASE H2O retention. So when ADH is release this will cause concentrate or dilute urine? It will cause the urine to be ___ because water is ___ to the BLOOD. When urine is concentrated it is the sign that body NEEDS water. |
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diuresis
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increased secretion of urine
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HYPOPERFUSION/RENIN/CIRCULATION
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Hormonal Regulation
Renin-angiotensin system - this will response to low blood flow (low KINDY ___). When kidneys are HYPOPERFUSE (not enough blood flow around there) ___ will be released. Renin will cause VASOCONSTRICTION and RETENTION of sodium which will pull volume back into ___ - making the blood pressure go UP so the kidney can get Better PERFUSION. This will increase the BP by vasoconstriction. This cause the production of ANGIOTENSINOGEN which is powerful VASOCONSTRICTION. |
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ALDOSTRONE
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Hormonal Regulation
Production of angiotensil will stimulate Release of ___ will cause kidney to REABSORB the Na and water. This also will make the BP to go UP. |
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INCREASE
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Hormonal Regulation
INCREASED Thyroid hormone cause ___ cardiac output and INCREASED urine output |
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opposes
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Hormonal Regulation
Brain Natriuretic Peptide (BNP)- ___ (attempt to prevent) RENIN-ANGIOTENSIN circle - involved with LEFT heart failure( don't worry about that) |
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EXTRA/WEAK/LOW
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Sodium Na
•Main ___cellular cation:regulates fluid volume, nerve and muscle impulses So decrease in Na will cause patient to be ___, DRY mucous membrane, ___ BP •Kidney reabsorbs Na into circulation pulling H2O in. When Body has increase in Na that will cause the patient not only be thirsty (to offset the amount of sodium in blood) but also BP go UP, dry mucous membrane (it try to pull the moisture BACK into circulation) |
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135-145
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Sodium Na level ___-___
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INTRA/ABDOMINAL/DECREASE
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Potassium K
•Main ___cellular cation:muscle contraction, cardiac conduction Increase in potassium will cause in ___ cramping, ___ in urine output and will be evident in EKG ( has so much to do with electrical chart) •kidneys eliminate |
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Hypokalimia/DECREASE
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___:low POTASSIUM - ___ bowel sounds, abdominal cramping, (heart block) heart will not carry conduction, will not BEAT
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3.5-5
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Potassium K level ___-___
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ECF/EXTRA/PRE/OSTEOPOROSIS
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Calcium Ca
•mainly in ___ (___cellular fluid);99% in the bone •if you don't have enough Ca in ECF body will pull Out of the bones to keep the blood level UP. So even though amount of Ca in blood is mini (compare to amount in bone) the body will pull it out of the bone to supply the blood. Insufficiency leads to ___ menopause women will be susceptible to have ___. •50% of Caucasian females will suffer from osteoporotic fracture •Bone health Calcium is important for neuromuscular function;cardiac function;blood clotting |
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8.5-10.5
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Calcium Ca level ___
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ICF
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Magnesium Mg
•in ___ (___cellular fluid); bone; many cellular functions •alcoholism leads to low levels of Mg |
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ECF/stomach
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Chloride Cl
•___;bound to other ions for ex:Can bind to H to make HCL (HYDROCHLORIC acid found in ___) |
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ICF/Inverse
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Phosphate PO₄
•___ anion •Bound with calcium in teeth and bones •___ relationship of PO₄and Mg. when one goes UP the other goes DOWN. •in charge of muscle, nerve, RBC function |
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Bicarbonate/buffer
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___; HCO₃
•ICF and ECF; acid-base balance •Regulated by kidneys will excrete or secret •Produced by body to act as ___. |
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buffer
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substance that maintains a fairly constant pH in a solution by accepting H+ ions when their levels rise and donating H+ ions when their levels fall
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ISOTONIC
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___ solution that wound not shift fluids in and out
Hypotonic and hypertonic solution are SPECIALITY solutions and are used for SHORT term |
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___
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-Serum osmolarity:275-295 mOsm/L ( particles in blood)
-ISO-osmotic:275-295 the same number of particles as blood Hypotonic and hypertonic solution are SPECIALITY solutions and are used for SHORT term —HYPO-osmotic:less than 275. Fewer particles MORE water The lower the osmolarity the more it wants water to enter the cell Therefore restrict po fluids, give hypertonic IVF. -HYPER-osmotic:greater than 295. LOTS of particles and less WATER The higher the osmolarity or concentration of a solution, the greater it's pulling power Therefore encourage po fluids, give hypotonic IVF. |
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___
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Osmolarity and osmolality are interchangeable
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ISOTONIC
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with ___ solution will be NO fluid shifts, only will stay in the VESSEL and INCREASE blood volume
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hypotonic/DEHYDRATION
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___ solution will cause cell to ABSORB the water, cells will SWELL up. Hypotonic solutions are used for ___
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Hypertonic/EDEMA
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___ solution will cause pulling water from CELLS, tissues to blood
We will give the hypertonic solution to patient with ___ Water leaves cells to go into extracellular fluid |
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Isotonic
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___ Solution, 0.9% saline (normal) saline
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Isotonic
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___ Solution lactated Ringer's solution,
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Isotonic
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___ Solution, D5W (dextrose 5% in WATER)
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MALNOURISHED
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D5W (dextrose 5% in WATER)- there is only 170-180 calories in that bag so if patient gets only this they become ___
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___
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Usually you will use normal saline or lacerated ringers solution to run kvo or keep the vein upon to increase the volume
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hypertonic
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______ Solutions- more solute concentration than isotonic solutions ex.
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hypertonic
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D5W plus 0.9% normal saline together - this would be _____
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hypertonic
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D5 0.9% NaCl- ______
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hypertonic
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D50% in water enter the body and become ______
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hypertonic
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D5 0.45% NaCl - ______ in the bag
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PB
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Hypertonic solutions gonna be used for Edema, but they will cause shift of fluids into the vessel so it will bring ___ up.
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hypotonic
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___ Solutions- anything less then ISOTONIC solution. So it would be less then 0.9% NaCl would be 0.45 saline (1/2 of normal) or -
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hypotonic
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0.3 NS, or D2.5%W this would be less then D5W(isotonic) - would be
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normal saline
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If you get IV solution with 180 calories of sugar in it. What's gonna happen to that sugar when it's in the blood stream. The body will use that sugar for energy (it will be removed from the IV solution pretty quickly. The IV tonicity will be now extremely HYPOTONIC solution - WATER. You take D5 out of W - you left with water.
So if u have hypertonic solution ex: D5W 0.9% NaCl it will turn into ___ |
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Hypovolemia/EXTRA/INTRA
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___ - loss of isotonic fluids form ___cellular space, patient lost volume ex: through sweating or bleeding, Dehydration (cell is low on H₂) through:vomiting NG tube drainage, fever, sweating, diarrhea, 3rd spacing fluid shift (accumulation of fluids in abdomen-came from ___vascular space to abdominal cavity), burns, D, surgery
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Hypovolemia
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___- loss fluids and solutes.
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___
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For fluid deficit imbalance risk will be:comatose patients, INFANTS (especially with prolonged fever), elderly
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___
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normal PCO2 is 35-45
<35 alkalosis. >45 acidosis normal HCO3 is 22-26 <22 acidosis. > 26 alkalosis |
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tachycardia
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As fluid volume increases to the point of fluid volume excess, the client will develop ___ (increase in rate) and a bounding pulse (increase in volume)
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diuretic/excess
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Furosemide (Lasix)
The administration of a ___ is an expected prescription for a client with fluid volume ___ |
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___
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Potassium chloride 40 mEq IV push now.
Clara's serum potassium is low (3mEq/L). She needs potassium replacement, but potassium chloride should never be administered IV PUSH. A prescription for potassium chloride diluted in an IV solution to be administered over several hours should be obtained from the healthcare provider. |
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hypokalemia
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Hydrochlorothiazide, a potassium-wasting diuretic, may cause significant ___ Use of hydrochlorothiazide may also result in a decrease in serum magnesium and sodium and an increase in serum calcium and glucose.
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