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'YRbnm Yp$O0Kb/gT^lnm'N1Y c. cQ4lTǏY gO(u)R?\BR b6R\{Q8T6e0 04N^hs0 9hnc: z^ g N T 8^ur g4YUf0Ɖɉ!j|0o1_eR0 d~0%N͑^y_ Nn0uc'`uu0qS\Q1_0fI{09hnc: z^ 4N^\NOn'`:4lR:N N^ 1 0{^:` guONa 4YUf0Kb(g0S4n Nf>f0@n(W 135mmol/L N N ?\-NQ\099'tD&  'T2 0-N^:d NurY 8^ gv`_ UTT d~ @S N3z[ ƉR!j| ?\ϑ\0@n(W 130mmol/L N N0 3 0͑^:uN^y_ Nn0qS\Q1_bm1Y Qs(gP uf08^SuOKQ0@n(W 120mmol/L N N0 0ʋe0 9hncSOm'N1YuSS N4N^hs N,ʋeeV0SPR NRhgfnxʋe0 a. ?\ Na+ Km[ 8^ gf>fQ\ b. @n Na+ Km[(W 135mmol/L N Ne hf gNO@u v^S$R[: z^ c. @FmnSMNO d. ~~ހpe0@~ˆ}vϑ0@~ހk[0@^ˆ}v.lS?\ }GW gXؚ ?\k͑(W 1.010 N N0 0luce0j+'/'/j'35- 6 'ygluuVY HQeEQ@[ϑ [:YN:4lvyrp Ǒ(u+Tvnmbؚnv4lY nl N~ckSOmvNOnr`TeEQ@[ϑ0eEQvvϑmmol =[@ck8^fMNO @FmnS(Wck8^V0?\k͑Xؚ0~~ހpe0@~ˆ}vϑT@~ހk[ gf>fXؚ h:y@mSm)0_eS\O@lRgKm[ N$R[ g&Txxs^a1Y0 0luce0'6OW'<HQ=\SYt_wI{n'`1Y4lvSV NQ\4lTv'N1Y0[~ހYmϑvQ\ N,S(uI{nv4lbs^avm=\_eEQ@[ϑ09hnc d~T@S NMI{ureg0OSOm'N1Yϑ ]SO͑v5% S_eQ NmSO~3.0L  cSO͑60kg{ 0Nb` Y@[ϑ b c@~ހk[eg{emSOϑ0 eI{nv4lϑL =@~ހk[ NGSf __SSuuvur@bcv0S go1_eR0v`_UTT0UawI{ SO͑XR v͂}v nm0 0ʋe0 9hncuSS4N^hsN,YSʋe01uN@mzʑ [[hgSSs~~ހpe0@~ˆ}v0@~ހk[T@Fmˆ}vϑGW gMNO @n0/lKm[_NMNO0' 'Z0luce0 2͑Nlu0[R NhQT[fSub)R?\o }RlǏYv`Q ^%N$ $' ''&N"qN;N/fc~ހYm-NyP[Sm^v_8^SS SbNO@uhypokalemia Tؚ@uhyperkalemia 0sQN(Wut`Q N~ހQyP[Sm^v9eSSvQ[:gSOvq_TI{ ďN؏wKN NY0 N0NO@u 0i0 NSOhQ`YLuDdeQ keNߘir-NDdeQ~50-100mmol 901u\8T6e0/fcTs^av;NhV[ \tnm-NvHQ(Wяf\{Q[hQ8T6e NT܏f\{~ހTƖT{~ހQ\ǏiRvRlQeg N?\cQ O(WSOQ~cs^a0FO/f NSODdeQ Ne  Nf>f0WQ\c OOYuNSOQ Eef_w:0@nSm^(W3.5^5.5mmol/L s^GW4.2mmol/L08^N@n3.5mmol/LeyNO@0FO/f @nMNO v^ NN[h:ySOQ: Sh:y~ހYm-NvSm^ hQ:e @n NN[MNO0Ee4N^ N^~TuST4N^hsRg$Re0 0uVf[0'  N R'0_w:bNO@uvSV_Y 8^v ga.DdeQ N Ygۏߘ N ~uNeme g*g~evmSO b(W%{Q/ecǏ z-N %{Qm-NvveEQ Nb._c1YǏY YUTT0yl0ÀQSSmSSv 'Yϑ"N1YmSm g^(u?\0)R?\xI{)R?\BRSv(o }I{ONcQǏYc.(WSOQR^_8^ Y'Yϑla|N\ }T(u bx-Nke O'YϑleQ~ހQ QsNO@u0 04N^hs0 4N^hsT~ހQ0Y:ONv%N͑ z^vsQ f;Nv/fSQNNO@Suv^0@nK+2.5mmol/Le ur%N͑0wegQSu: urQsŏ u_ws{k0'R5=a  'X(1)0^y~|~ hs:N^y~0^o'`Q0S_@nK+3.0mmol/Le SQsVo1_eR NON2.5mmol/Le SQso+v NVg:NzQ qS\ߏbm1Y0S_|T8TS/}eRS_w|T8TV0-Ng^y~|~hsur:N|^yb0&P `0^y_m o0Uaw0^y_ Nn0ufI{0 (2)0mS|~ :S_wRQ1_ { gߘ2k N/c0v`_0Oy %N͑NO@S_wy0u'`O;0 (3)0_@{|~ NO@eN,:N_tQKY'`X:_ SQs_`0__1Y8^0%N͑SQs?b[;n0['`_RǏS[ gT_\PN6e)r`0dkY؏S_w_ _RQNO _ib'Y +g z@{ib _ @S NMI{0--'8  'N(4)0l?\|~ gNOS_w:'`uTRx Sm)R NM QsY?\Nk͑NO $\vQ/fY?\XY0ُSN܏f\{~ހS_c [b)R?\o }S^MNO 4l͑8T6eRMNO@b0SY :Ts^n _RQ SQs?\toYu uN8^fTv^vp0 (5)0xxs^a }qN NO@S[N"'`x-Nk0 0ʋe0 ;N9hncuST4N^hs0@nKm[@K+3.5mmol/Le QsursSS\OQʋe0FO(W:4lbx-Nke @nK+S N>f:yMNO0dkYS9hnc_5uVhg YOea0WS fQNO@`Q _5uVv;Nhs:NQ-Tg^ S-Tk NM TlNOs^0X[0Sv0PnbQsUlI{0 0luce0(('~ *  'Z(1)0N,Ǒ(uS g bN2BRϑ:N10%/lS30^40ml/dkg/lS+T13.4mmol 0/lSS gf gÀSS^ S(ug|jx:NsO1gg|jx+T4.5mmol 0 (2)0Y l/lS (W NS gb:%N͑vuNO(u08^(uSm^:N5%a|m1.0L-NReQ10%/lS10^20ml kg/lS_{GWSnl30^40minN N NSY cl0eϑƉu` [ \O:N2 8^bNeEQ/lS3^4g/d \O:Nlu R:N4^6gbfY0 (3)0elapa.?\ϑ_{(W30ml/hN Ne eQe &TRS_w@Ǐؚ0b.4O gx-Nk0@/lǏؚbR_c[ SQ^(u7(lx k/e6.3g +T34mmol SReQ0.5La|mQYn0C.Y nlv/lSSm^*YؚS:RoY _wuu uY ucT@hb_b0d.R_nlǏ_ @nSm^z6qXؚS[_d\P0e.K+ۏeQ~ހQv^_ba ~15hMb0R~ހQ0Ys^a (W~ހR Z'  &#" '| NhQY:'l0x-NkI{`Q N vs^aef ~1hTbf,@bN~ck:Sepee RdKNǏ%`b-N\Pbke~0f.: Te gNO@e ^lae V:NNO@ur__NO@@bcv NO@~ckT SQsNO@'`d&d0g.wgQ'Yϑebgee [g‰[ Km[@nS_5uVNMQSuؚ@ N0ؚ@u 0i0 @nKm[5.5mmol/Le y:Nؚ@u0Vؚ@u8^8^l gb_\ur 6q_\Pd ^SeSs Se2l0 0uVf[0 ck8^Nnߘ-NDdeQϑ܏NONcϑ Ee_wؚ@vSV'YYNRQ N gHe0WcQ SOQXY gsQ0SR:N N{|a.cV Y%`'`Rpzv\?\6k0vv(o } NI{0ZZ?'d:1:o 'Fb.ۏeQSOQ@mQ vǏY YY eQǏY Ǐ_ l'YBRϑR }vb'YBRϑ^X[@ g(u+ToirI{ c.~ހQyeQ~ހYm Y:'l0x-Nk0c~'`bd0'Yϑn@0'YϑQQ@0'Y@0$cS~T_I{GWSO~ހQʑQ0 SQNSSuu0@GSؚ z^0^I{ uNN,eyr_ur ;N/f[_Tšvk'`\O(u0 04N^hs0 1 0b6R_6e) Qs__ba __ NP %N͑e_[R0_\PdN _r`0NONa+ 0 NOCa2+0 ؚMg2+SRgRؚ@[_vqS[0ؚ@_5uVvyr_'`9eS/fegTlؚ \0Q-Tg^ TQsQRSlX[ PRg^0$$'4 '&2 0^y~ureg8^ gVSShTaɉ(g g^uON0xu0SO͂}v0nQ0@Sm^7mmol/Le V(g o+v HQ:Nr^ T:NV gTq_T0R|T8T Suzo`0 3 ؚ@e SN"'`x-Nk0 0ʋe0 QG g_wؚ@uSVvuN cؚf` ^~8^ۏL_5uVhg YSs_5uVvؚ@u9eS sSSnxʋ0@nKm[8^>f:y@Xؚ0 0luce0 HQc6R_wؚ@uvSVSluSSu0NeSsؚ@ue ^zsS\Pbke ygǑSOb_v%`Qece [bvk'`\O(uOOT~ހQlycdSOQǏYv NMNO@nSm^0(['&1'"%`Qecea.YlBR10%a|x10^20ml S͑ YO(u N g[b\O(u ㉾[_vk'`\O(u0b30^40mlReQmSOnl0b.Y l\5%xx"lnm60^100ml b11.2%sNxnm40^60ml KNTSQl\xx"l100^200mlbsNxnm60^100ml ُyؚnx'`vSibEQ@[ϑ Nzʑ@nSm^ OyP[yeQ~ހQ ~ckx-NkNMNO@nSm^ ؏ gleQv,[_N g[b\O(u0c.(u25%^50%a|100^200mlR\ }4g|R1Uckĉ\ } \OY nl S_a|Tb|Se \leQ~ހQ0d.l\?XbT [_ O[;n gN[\O(u0e.gul gygT@mg R NhQ ~ NluT @nN N NMeSǑ(u0f.3yP[Nbchv^(u 15g,S g,4!k/d SNmSS:d&^pYvyP[ NSReQ10%a|200ml-N\OOYuLp0('n" ?( F,{N xxs^a }qN (Acid-Base Disturbances)$$'$  fnxvQ*NW,gi_ NHN/fxNHN/fx [IN 1uNǏS_eQl gvcKm[@mpH / 'PNHN/fV[xFixed Acid NHN/fV[xFixed Base ? NUO^%cS'`v4yP[b3yP[yV[xbV[x /fNS%cS'`xH2CO3SubCO2 v:S+Rv0 HQ N$N*N[IN-NvxNxN/fN x/f4yP[ x/f3yP[ vi_vT|v0Vdk 9eyV[x:NV[4yP[ V[x:NV[3yP[ kYS_ vMR]nǑ(u0vQ!kV[4yP[R$NR:NY sSV[4yP[TQ4yP[0V:N(W[EuO-N V[4yP[XYS/fAGX'Y{|N"'`x-Nk Q4yP[XYRS/fN"'`x-Nk0 xxs^ax{|W}T T NvmqN gNeg e.s N gNyN@/lؚNOeg}T Txxs^axvel R_~weg[/fُ7hv)'''/'/'/''('  U'N0:gSO[xxs^av N @FmQ|~HCO3-/H2CO3Pr/HPrHPO42-/ H2PO4 ~~ހ|~Hb-/HHbHbO2-/HHbO2HPO42-/H2PO4- ~~mQ|~HCO3-/ H2CO3HPO42-/H2PO4- N v\O(u Ǐ9eS|T8TЏR CO2cQϑ c6R@Fm[H2CO3]Sm^0  N v\O(u ǏcQH+cV[x T͑8T6eHCO3-Ox eg@Fm[HCO3- ] V ~ހvQ\O(u 10~ހQYyP[Nbc H+-K+Nbc Cl- -HCO3-Nbc '//'/'/ '//'/'//'/'//'/'//'/'// '//'/'/'//'/'/<'/ '// '//'/'/'/'//'6   'x20Q\O(uS b(u~g N0S f@mxxs^a rQv8^(uch N xx^pH i_nm-NH+Sm^v[pe0 ck8^7.45 N 9hncwYuV 1 |T8T'`xxs^a }qN [H2CO3]SS9eS 2 N"'`xxs^a }qN [HCO3-]SS9eS  N 9hncNPrQ 1 NP'`[HCO3-/ H2CO3]=20/1pH=7.35^7.45 2 1YNP'` pHQck8^V0,Z'/'/'//'//'/'/&'L'   $'V 9hncxx"N1YrQ 1 US~'`xxs^a }qN 2 mT'`xxs^a }qN 1 S͑mT'`xxs^a }qN 2 N͑mT'`xxs^a }qN V0US~'`xxs^a }qN N N"'`x-Nk metabolic acidosis 10i_1u@Fm[HCO3-]vSS'`Q\@b [vpH NM0 20SV ;NSVV[xǏY HCO3-"N1Y! `!0HCO3-"N1YǏY 1 vc"N1YǏY 2 @mzʑ OHCO3-Sm^ NMX'//.'[ %'|a!0V[xǏY HCO3-Q"N1Y 1 V[xNuǏY `$sNxx-Nklactic acidosis a$nux-Nkketo-acidosis  2 Yn'`V[xDdeQǏY `$4lhgx-Nk a$+T/lvbx'`oirDdeQǏY 3 V[xclx b!0ؚ@ K N~ހQH Nbc ܏f\{ NvlH Q\S8^'`x'`?\ 30R{| `!0AGXؚ'`Nx yrpAGGSؚ @/lck8^'/'/ '/'' 3  &':g6R@FmV[x! a!0AGck8^'`Nx yrpAGck8^ @/lGSؚ :g6RHCO3-"N1Y! 40:gSOvNP T:g6Rv~S%c\O(u0 `!00~ހYmvQ\O(u a!00vNP b!00~ހvQ\O(u c!00vNP 50@lyrppH PaCO2 SB AB BB BE 60[:gSOvq_T `!0_@{|~1 __1Y8^@Xؚ@b 2 _6e)RMNONzN~Tˆ}vb6RQAmb6RFmQʑ>e  Z'l   MD'' 3 @{|~[?Q6ZvS^'`MNO a!0CNS-Ngb6R:g6RGABAubXYATPubMNO b!05u(N"ؚ@u:g6R~ހQY"lNbcXRc"lXY cQ\0 f! 2lSR2lSSu9eU__s ~c5u(s^a^(uwx'`o0 N |T8T'`x-Nk respiratory acidosis 10i_1uPaCO2bH2CO3 SS'`GSؚ@b[vpH NM0 20SV ;NSVlx CO28TeQǏY0 `!0lx|T8T-Ngb6R0|T8Tu0|T8TS;^X0^0uS|T8T:gO(u NS_ a!0CO28TeQǏYj'/5'/'\ 3('30R{| %`'`|T8T'`x-Nkba'`|T8T'`x-Nk 40:gSOvNP `!0~ހQYyP[NbcT~ހQQ%`'`|Tx;NNP (1)~ހQY H+-K+Nbc (2) RBCQYHCO3 Cl-Nbc ~g@pHXؚ @Xؚ @/lMNO a!0vNPba'`|Tx;NNP 50@lyrp 60[:gSOvq_TW,g TNx Nx%N͑0 702lSR TNx R:_|T8T:g{t0  N N"'`x-Nkmetabolic alkalosis 10i_1u@Fm[HCO3-]vSS'`GSؚ[vpHGSؚ0 20SV ;NSVH+"N1Y HCO3-ǏϑwdF'/'/'//'/'//'/'//'E[)'`!.H+"N1Y 1 ~ À"N1Y "N1YH+"N1YCL-NO/l'`x-Nk "N1YK+NO'`x-Nk "N1YSOm 2 N"N1Yoirvq_T,uuvq_T a!.HCO3-Ǐϑw b!.H+T~ހQly NO@K N~ހQH Nbc܏f\{ NvlH XRS8^'`x'`?\ 30R{| `!.v4lS^'`x-Nksaline-responsive alkalosis yrp gHe_s@ϑ NbNO/l b a!v4lbb'`x-Nksaline-resistant alkalosis yrpVXYubNO@ b 40:gSOvNPZ'/'/'/ '/('//'/ '/'/ '/' "  *'T:g6Rv~S%c\O(u0~ހYmvQ\O(uvNP~ހQYyP[NbcvNP 50@lyrp pH PaCO2 SB AB BB BE 60[:gSOvq_T `!00CNS-NgtQKY:g6R1 GABAQ\ 2 'lyf~]y!~~:'l a!00^y~tQKY'` @8nyQ\ b!00NO@u 702lSR 2lSSu~ck@pHv4lS^'`x-Nk`~NI{ _bJS _vv4l0 V |T8T'`x-Nk (respiratory alkalosis)FZ;'/'~4  @!+'>10i_1uNPaCO2bH2CO3 SS'`Q\[vpHGSؚ0 20SV ;NSVlǏ^0 `!NO _'`:'l a!u` b!|T8T-NgS:Ro c!N]|T8T:gO(u NS_ 30R{| `!%`'`|T8T'`x-Nk a!ba'`|T8T'`x-Nk 40:gSOvNP `!~ހQYyP[NbcT~ހQQ%`'`|Tx;NNP (1) ~ހQYH+-K+Nbc '/'/'/'/'/'`z,'(2) ~~ހQYHCO3--CL-Nbc ~g@pHMNO @MNO @/lXؚ a!vNPba'`|Tx;NNP 50@lyrppH PaCO2 SB AB BB BE 60[:gSOvq_T W,g TNx Kbd1_ (W%`'`|TxeffQs@{6e) ~~:'lR͑0 702lSR TNx%`'`|TxS8TeQ5%CO2mTlSO 0 US~WABD\~ 1 i_ 9hncSSSSV }SeT}T T0 2 NPSSĉ_ NPSSNSSSSeTN0 . '/'/5'/Z' '.'~  %A 1 -'v3@lyrp |T8T'`ABD @mpHNvQ[chSSeTvS N"'`ABD @mpHNvQ[chSSeTv T0 4 SVT:g6R NxV[xub!SHCO3-"N1Y!!HCO3-MNO0 |TxCO2cQQ\8TeQǏY O@Fm[H2CO3]GSؚ0 Nx( "N1Y (#/ Ǐϑw @(#/ XY0 |TxlǏ^CO2|TQǏY O@-N[H2CO3]MNO0 5 [:gSOvq_TM'//'// '/'/'/ '/'// '// '/ '/'/'   ' !.'  CNS yP[9eS vQ[ x-Nk b6R'` }qN @Xؚ @{u __1Y8^ 6e)RMNO x-Nk tQKY'` }qN @MNO uc 6 NP (1) N"'`ABD,T:g6Rw\O(u $\vQ/fT |T8T'`ABD,~ހQYyP[Nbc/f%`'` }qNv;N:g6R$N[yP[Nbc /fba'` }qNv;N:g6R0 2 NP/f gP^v0 3 pHf Nck8^0 N vm'`mTWABD $NV }SSeTNNx+NxdY pHSSS NS Sck8^ OPؚbOPNO0  N mTWABDNPV }vSS z^GW]Ǐck8^NPV0 mQ0xxs^a }qN{|Wv$Re NRN w{f$Rel NR\Yych{Sb Ny v^(u{4Yh:yvQGSM 0 N w N wpH[xx 1 pHGSؚ1YPWx-Nk, pHMNO1YPx-NkZZ Z'$''''' '  K  %22 pHck8^S/f  '1 xxs^a 2 NP'`US~'`!"$ 3 mT'`vmW!"$ N wSSV }[N|T uS-N gx 1YxbvS`Q :NNP'`N"'`ABD uS-N gǏ^lbvS`Q :NNP'`|T8T'`ABD0 N w ~S'`SS /f&T&{TNPĉ_[USm 1 ~S'`SSveT: (1) NSS'`SSeTN US~WABD mTWABD (2)NSS'`SSeTvS mTWlZ$' '>''@'I6&3'R ~S'`SS vpe

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'~30Vnv\O(uVnaldosterone /f Nzv(tr&^Rlvvv(o }0Vnv;N\O(u/fOۏ܏f\{TƖT{[Na+v;NR͑8T6e TeǏNa+0-K+TNa+-HNbc OۏK+TH+vcQ @bN􋛑Vn gc0c"l0Ov\O(u0@wNa+;NR͑8T6evXR Cl-T4lv͑8T6e_NXY SVn_N gO4l\O(u0 40 ,{ NVP[ v\O(u gN(W(ur\Ov[-N‰[0R S_~ހYm[ϑXRe @Fm-NQsNyb6R\{͑8T6eNa+N [?\cQXYv'`(*gfvir( y:N yo } natriuretic hormone b ,{ NVP[ 0FOُeb؏ gY g_f0 gNDe_N*g[ُyir(vX[(W0 50_?b)RVP[v\O(u@@'  ' 3  52?'8ANFTeg_Ny:N_?b)RYatrial natriuretic polypeptide ANP V:N]~f[/fNyY0ANP;NX[(WNTsNRirvQ-N_NSbNv_?b~ހv~ހFm-N0Rir[f %`'`v@[ϑXRSOANPʑ>eeQ@ N _w:_'Yv)RT)R?\\O(u0@[ϑXRS/fǏXؚS_?bSR ur __?b OANPʑ>ev0SKN P6R04lDdeQbQ\Y V_@ϑRQ\ANPvʑ>e0]~f NNRirvR 00 Nzv(tr&^I{ gANPvyr_SSO ANP/fǏُNSSO\O(uN~ހ NvxsSv N~ހQvsxcGMP \O:N,{NOO S%cvQHe^v0 Z'  ,-'0602urezo }v\O(u2urezo }/f2urezRlvo }0[Oۏ܏f\{vƖT{[Ca2 v͑8T6e b6Rяf\{[xxvv͑8T6e b6Rяf\{[Na 0K+THCO3-v͑8T6e02urezo }؏Oۏ\{[Mg2 v͑8T6e0 ,{N @lRg N, @l/fc@m-N@b+TvO2TCO2lSO0@lRg/fċNuN|T8T0'lSSxxs^ar`v_ch0[Sb@mvpH0PO20PCO2vKm[

eQfYvO2 N^:gSOv0CO2SNǏH+SNBohrHe^ ؏vcNHb~Tb_bHbNHCOO gRN3z[TWga v^(WЏCO2-Nw gN[\O(u0  N PO20PCO20pH02 3-DPG[HbЏlSOvq_T @~ˆ}vd\O:NO2SCO2vЏ}SOY ؏c6RCO2ЏǏ z-NH+ϑvY\ \O:NQCO2NuvH2CO3-Nw g͑v\O(u0H2CO3v60/f(WHbЏ}O2SCO2Ǐ z-Nʑ>eQH+ ۏ b:N1_xN[bQH2CO3v\O(u sSHbNO2bCO2SuvS^NvOS v^ǏBohrHe^p`S_0WYtNegCO2vH+ OpHeO2 RxSlBRI{mTm OُNS^Ǐ z(Wwzz[agN NۏL @m-N@b+TCO20O2TN2hQʑ>eۏ[\wzz{vmbKN N 6qTKmϑ@bʑlSOvSR0 TS(uCO28T6eBRSO28T6eBRR+R\$NylSO8T6e 9hncSRv9eS Q{QCO2TO2v+Tϑ0b'!'/&'/'/'/"'/'/'/'/'-#'20elf[ċN lQnxS` 6q d\OA~ SO(u'Yϑ4l gfalgsX s(W\O(u0SY؏O(uSf[lKm[@FmHCO3 +Tϑ dkld\OBl%Ne'YhVCQN0peW[Џ{>f:yO\TSbpS:gI{N ۏLꁨRSRg vQ@b7hT\ hKm^_ Qnx0 105ug|~ 1 pHKm[|~ SbpHKm[5ugsSst5ug0SS5ugS$Ny5ugvmSON(0@7h-NvH+Nst5ug-Nvё^\yP[ۏLNbc Nu5uMO] v^N@7hvH+Sm^bckk NKNX[(W@w[pesQ|0dnZ<'//Q'/'/0'/'/'/i'/'/'9P >'62 PCO25ugPCO25ug^\NCO2lOe5ug0;N1uyrkst5ugTAg/AgClSk5ugS5ugQm~b05u-N'`CO2Ǐ &^5uwvH+S&^5uwvHCO3 NǏ0CO2ibceeQ5ugQ N5ug̑vxx"lnmSuS^ OvQQvNaHCO30NaClnmvpHene cBl ǑSv@h,g^(W30RQhKm[k Y30RT NhKm ^\h,gnNQ4l-NOX[ gY NǏ2\e (W30R0R2\eKN @PO2

f:y READY sS]QY}Y dkeSۏLKmϑ0N,Kmϑ(ul\hVۏ7hbk~{ۏ7h$Nye_ۏL0l'Z'/'/'r/<h&TdN0@lhKmv(ϑc6R  ' N @lhKmpencv!h N (ϑc6R vMRO(uv@lRgvSՋBR cW( N TR:N4lBRQm0hQ@0@mW(0N @lxSTirVy0EE' EWg,{ N 4l0N" }qN ' 4l0N" }qN8^ TebHQTSu sQ|[R 8^Nw }qN gTyR{|el :NNONt 9hnc4N^ N8^Ǒ(uvelR:N14lSb1Y T4l-NkۏL0 N014l 14ldehydration |cSOm[ϑvf>fQ\014l c~ހYmvnS N TSR:N Ny{|W0N1Y4l:N;N y:NؚnSS '`14lN1Y:N;N y:NNOn~S '`14l4l0T cvQ(W@Fm-Nv+TϑbkO"N1Y y:NI{n'`14l0 N ؚnSS '`14l 0i0 4lT Te'N1Y FO:4lYN: Ee@nؚN Z'U '8ck8^V ~ހYmHTؚnr`0S_:4lYN:e ~ހYmnSXR b)R?\o }RlXY \{[4lv͑8T6eXR ?\ϑQ\0VnRlXR T4lvQ8T6eXR N~c@[ϑ0Y~~:4l ~ހYmnSۏNekXؚ ~ހQmyT~ހY g~/f~ހQ:4lv z^Ǐ~ހYm:4lv z^0~ހ:4l\_wRx0 0uVf[0 ;N ga.DdeQ4lϑ N YY$O0f0ߘ{uuvTTV Nۏߘ qS͑uN~4l N ;rؚnnߘbl'Yϑؚnv4lnmI{b.4l'N1YǏY *gSeeEQ Yؚp0'YϑQWl0'Ybyp$O0l{R_0yKb/geQef20|?\ufI{0 04N^hs0('.9<'9hncur N T N,\ؚn'`:4lR:N N^ {^:4ld gS4nY YevQ[ur0:4lϑ:NSO͑v2%^4%0 -N^:4l gg^S4n 4OONR0?\\0?\kؚ͑0Ur^ q0v9_'`]0fQ\ :gSO\ NQ~S0RnS =\ϑOc@[ϑ0 }-Vn|~tQKY OQ\c Cl-T4lvQ8T6eXR0Ee?\-N/lS+Tϑf>fMNO0@[ϑ NMSO:RoWSOTS Ob)R?\o }RlXY 4lQ8T6eXR [\?\0Y@[ϑ NMSO~~Q\ NNPR NQY~c@[ϑe \QsOKQ0ُyV'Yϑ1Y vOKQ SyNO'`OKQ0D='/u'.u 'p0uVf[0 [NOn'`:4lvSVuY YyKb/guXT8^SV/f~ހYm"N1YT SeEQN4lbveEQ N Nv[0WSOQ:uN:4l08^SV a. ÀSmSmc~'`'N1Y Yyl0UTT0mSSv0h;I{ mSm'Yϑ'N1Y b. 'YRbnm Yp$O0Kb/gT^lnm'N1Y c. cQ4lTǏY gO(u)R?\BR b6R\{Q8T6e0 04N^hs0 9hnc: z^ g N T 8^ur g4YUf0Ɖɉ!j|0o1_eR0 d~0%N͑^y_ Nn0uc'`uu0qS\Q1_0fI{09hnc: z^ 4N^\NOn'`:4lR:N N^ 1 0{^:` guONa 4YUf0Kb(g0S4n Nf>f0@n(W 135mmol/L N N ?\-NQ\099'tD&  'T2 0-N^:d NurY 8^ gv`_ UTT d~ @S N3z[ ƉR!j| ?\ϑ\0@n(W 130mmol/L N N0 3 0͑^:uN^y_ Nn0qS\Q1_bm1Y Qs(gP uf08^SuOKQ0@n(W 120mmol/L N N0 0ʋe0 9hncSOm'N1YuSS N4N^hs N,ʋeeV0SPR NRhgfnxʋe0 a. ?\ Na+ Km[ 8^ gf>fQ\ b. @n Na+ Km[(W 135mmol/L N Ne hf gNO@u v^S$R[: z^ c. @FmnSMNO d. ~~ހpe0@~ˆ}vϑ0@~ހk[0@^ˆ}v.lS?\ }GW gXؚ ?\k͑(W 1.010 N N0 0luce0j+'/'/j'35- 6 'ygluuVY HQeEQ@[ϑ [:YN:4lvyrp Ǒ(u+Tvnmbؚnv4lY nl N~ckSOmvNOnr`TeEQ@[ϑ0eEQvvϑmmol =[@ck8^fMNO @FmnS(Wck8^V0?\k͑Xؚ0~~ހpe0@~ˆ}vϑT@~ހk[ gf>fXؚ h:y@mSm)0_eS\O@lRgKm[ N$R[ g&Txxs^a1Y0 0luce0'6OW'<HQ=\SYt_wI{n'`1Y4lvSV NQ\4lTv'N1Y0[~ހYmϑvQ\ N,S(uI{nv4lbs^avm=\_eEQ@[ϑ09hnc d~T@S NMI{ureg0OSOm'N1Yϑ ]SO͑v5% S_eQ NmSO~3.0L  cSO͑60kg{ 0Nb` Y@[ϑ b c@~ހk[eg{emSOϑ0 eI{nv4lϑL =@~ހk[ NGSf __SSuuvur@bcv0S go1_eR0v`_UTT0UawI{ SO͑XR v͂}v nm0 0ʋe0 9hncuSS4N^hsN,YSʋe01uN@mzʑ [[hgSSs~~ހpe0@~ˆ}v0@~ހk[T@Fmˆ}vϑGW gMNO @n0/lKm[_NMNO0' 'Z0luce0 2͑Nlu0[R NhQT[fSub)R?\o }RlǏYv`Q ^%N$ $' ''&N"qN;N/fc~ހYm-NyP[Sm^v_8^SS SbNO@uhypokalemia Tؚ@uhyperkalemia 0sQN(Wut`Q N~ހQyP[Sm^v9eSSvQ[:gSOvq_TI{ ďN؏wKN NY0 N0NO@u 0i0 NSOhQ`YLuDdeQ keNߘir-NDdeQ~50-100mmol 901u\8T6e0/fcTs^av;NhV[ \tnm-NvHQ(Wяf\{Q[hQ8T6e NT܏f\{~ހTƖT{~ހQ\ǏiRvRlQeg N?\cQ O(WSOQ~cs^a0FO/f NSODdeQ Ne  Nf>f0WQ\c OOYuNSOQ Eef_w:0@nSm^(W3.5^5.5mmol/L s^GW4.2mmol/L08^N@n3.5mmol/LeyNO@0FO/f @nMNO v^ NN[h:ySOQ: Sh:y~ހYm-NvSm^ hQ:e @n NN[MNO0Ee4N^ N^~TuST4N^hsRg$Re0 0uVf[0'  N R'0_w:bNO@uvSV_Y 8^v ga.DdeQ N Ygۏߘ N ~uNeme g*g~evmSO b(W%{Q/ecǏ z-N %{Qm-NvveEQ Nb._c1YǏY YUTT0yl0ÀQSSmSSv 'Yϑ"N1YmSm g^(u?\0)R?\xI{)R?\BRSv(o }I{ONcQǏYc.(WSOQR^_8^ Y'Yϑla|N\ }T(u bx-Nke O'YϑleQ~ހQ QsNO@u0 04N^hs0 4N^hsT~ހQ0Y:ONv%N͑ z^vsQ f;Nv/fSQNNO@Suv^0@nK+2.5mmol/Le ur%N͑0wegQSu: urQsŏ u_ws{k0'R5=a  'X(1)0^y~|~ hs:N^y~0^o'`Q0S_@nK+3.0mmol/Le SQsVo1_eR NON2.5mmol/Le SQso+v NVg:NzQ qS\ߏbm1Y0S_|T8TS/}eRS_w|T8TV0-Ng^y~|~hsur:N|^yb0&P `0^y_m o0Uaw0^y_ Nn0ufI{0 (2)0mS|~ :S_wRQ1_ { gߘ2k N/c0v`_0Oy %N͑NO@S_wy0u'`O;0 (3)0_@{|~ NO@eN,:N_tQKY'`X:_ SQs_`0__1Y8^0%N͑SQs?b[;n0['`_RǏS[ gT_\PN6e)r`0dkY؏S_w_ _RQNO _ib'Y +g z@{ib _ @S NMI{0--'8  'N(4)0l?\|~ gNOS_w:'`uTRx Sm)R NM QsY?\Nk͑NO $\vQ/fY?\XY0ُSN܏f\{~ހS_c [b)R?\o }S^MNO 4l͑8T6eRMNO@b0SY :Ts^n _RQ SQs?\toYu uN8^fTv^vp0 (5)0xxs^a }qN NO@S[N"'`x-Nk0 0ʋe0 ;N9hncuST4N^hs0@nKm[@K+3.5mmol/Le QsursSS\OQʋe0FO(W:4lbx-Nke @nK+S N>f:yMNO0dkYS9hnc_5uVhg YOea0WS fQNO@`Q _5uVv;Nhs:NQ-Tg^ S-Tk NM TlNOs^0X[0Sv0PnbQsUlI{0 0luce0(('~ *  'Z(1)0N,Ǒ(uS g bN2BRϑ:N10%/lS30^40ml/dkg/lS+T13.4mmol 0/lSS gf gÀSS^ S(ug|jx:NsO1gg|jx+T4.5mmol 0 (2)0Y l/lS (W NS gb:%N͑vuNO(u08^(uSm^:N5%a|m1.0L-NReQ10%/lS10^20ml kg/lS_{GWSnl30^40minN N NSY cl0eϑƉu` [ \O:N2 8^bNeEQ/lS3^4g/d \O:Nlu R:N4^6gbfY0 (3)0elapa.?\ϑ_{(W30ml/hN Ne eQe &TRS_w@Ǐؚ0b.4O gx-Nk0@/lǏؚbR_c[ SQ^(u7(lx k/e6.3g +T34mmol SReQ0.5La|mQYn0C.Y nlv/lSSm^*YؚS:RoY _wuu uY ucT@hb_b0d.R_nlǏ_ @nSm^z6qXؚS[_d\P0e.K+ۏeQ~ހQv^_ba ~15hMb0R~ހQ0Ys^a (W~ހR Z'  &#" '| NhQY:'l0x-NkI{`Q N vs^aef ~1hTbf,@bN~ck:Sepee RdKNǏ%`b-N\Pbke~0f.: Te gNO@e ^lae V:NNO@ur__NO@@bcv NO@~ckT SQsNO@'`d&d0g.wgQ'Yϑebgee [g‰[ Km[@nS_5uVNMQSuؚ@ N0ؚ@u 0i0 @nKm[5.5mmol/Le y:Nؚ@u0Vؚ@u8^8^l gb_\ur 6q_\Pd ^SeSs Se2l0 0uVf[0 ck8^Nnߘ-NDdeQϑ܏NONcϑ Ee_wؚ@vSV'YYNRQ N gHe0WcQ SOQXY gsQ0SR:N N{|a.cV Y%`'`Rpzv\?\6k0vv(o } NI{0ZZ?'d:1:o 'Fb.ۏeQSOQ@mQ vǏY YY eQǏY Ǐ_ l'YBRϑR }vb'YBRϑ^X[@ g(u+ToirI{ c.~ހQyeQ~ހYm Y:'l0x-Nk0c~'`bd0'Yϑn@0'YϑQQ@0'Y@0$cS~T_I{GWSO~ހQʑQ0 SQNSSuu0@GSؚ z^0^I{ uNN,eyr_ur ;N/f[_Tšvk'`\O(u0 04N^hs0 1 0b6R_6e) Qs__ba __ NP %N͑e_[R0_\PdN _r`0NONa+ 0 NOCa2+0 ؚMg2+SRgRؚ@[_vqS[0ؚ@_5uVvyr_'`9eS/fegTlؚ \0Q-Tg^ TQsQRSlX[ PRg^0$$'4 '&2 0^y~ureg8^ gVSShTaɉ(g g^uON0xu0SO͂}v0nQ0@Sm^7mmol/Le V(g o+v HQ:Nr^ T:NV gTq_T0R|T8T Suzo`0 3 ؚ@e SN"'`x-Nk0 0ʋe0 QG g_wؚ@uSVvuN cؚf` ^~8^ۏL_5uVhg YSs_5uVvؚ@u9eS sSSnxʋ0@nKm[8^>f:y@Xؚ0 0luce0 HQc6R_wؚ@uvSVSluSSu0NeSsؚ@ue ^zsS\Pbke ygǑSOb_v%`Qece [bvk'`\O(uOOT~ހQlycdSOQǏYv NMNO@nSm^0(['&1'"%`Qecea.YlBR10%a|x10^20ml S͑ YO(u N g[b\O(u ㉾[_vk'`\O(u0b30^40mlReQmSOnl0b.Y l\5%xx"lnm60^100ml b11.2%sNxnm40^60ml KNTSQl\xx"l100^200mlbsNxnm60^100ml ُyؚnx'`vSibEQ@[ϑ Nzʑ@nSm^ OyP[yeQ~ހQ ~ckx-NkNMNO@nSm^ ؏ gleQv,[_N g[b\O(u0c.(u25%^50%a|100^200mlR\ }4g|R1Uckĉ\ } \OY nl S_a|Tb|Se \leQ~ހQ0d.l\?XbT [_ O[;n gN[\O(u0e.gul gygT@mg R NhQ ~ NluT @nN N NMeSǑ(u0f.3yP[Nbchv^(u 15g,S g,4!k/d SNmSS:d&^pYvyP[ NSReQ10%a|200ml-N\OOYuLp0('n" ?( F,{N xxs^a }qN (Acid-Base Disturbances)$$'$  fnxvQ*NW,gi_ NHN/fxNHN/fx [IN 1uNǏS_eQl gvcKm[@mpH / 'PNHN/fV[xFixed Acid NHN/fV[xFixed Base ? 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'/'/5'/Z' '.'~  %A 1 -'v3@lyrp |T8T'`ABD @mpHNvQ[chSSeTvS N"'`ABD @mpHNvQ[chSSeTv T0 4 SVT:g6R NxV[xub!SHCO3-"N1Y!!HCO3-MNO0 |TxCO2cQQ\8TeQǏY O@Fm[H2CO3]GSؚ0 Nx( "N1Y (#/ Ǐϑw @(#/ XY0 |TxlǏ^CO2|TQǏY O@-N[H2CO3]MNO0 5 [:gSOvq_TM'//'// '/'/'/ '/'// '// '/ '/'/'   ' !.'  CNS yP[9eS vQ[ x-Nk b6R'` }qN @Xؚ @{u __1Y8^ 6e)RMNO x-Nk tQKY'` }qN @MNO uc 6 NP (1) N"'`ABD,T:g6Rw\O(u $\vQ/fT |T8T'`ABD,~ހQYyP[Nbc/f%`'` }qNv;N:g6R$N[yP[Nbc /fba'` }qNv;N:g6R0 2 NP/f gP^v0 3 pHf Nck8^0 N vm'`mTWABD $NV }SSeTNNx+NxdY pHSSS NS Sck8^ OPؚbOPNO0  N mTWABDNPV }vSS z^GW]Ǐck8^NPV0 mQ0xxs^a }qN{|Wv$Re NRN w{f$Rel NR\Yych{Sb Ny v^(u{4Yh:yvQGSM 0 N w N wpH[xx 1 pHGSؚ1YPWx-Nk, pHMNO1YPx-NkZZ Z'$''''' '  K  %22 pHck8^S/f  '1 xxs^a 2 NP'`US~'`!"$ 3 mT'`vmW!"$ N wSSV }[N|T uS-N gx 1YxbvS`Q :NNP'`N"'`ABD uS-N gǏ^lbvS`Q :NNP'`|T8T'`ABD0 N w ~S'`SS /f&T&{TNPĉ_[USm 1 ~S'`SSveT: (1) NSS'`SSeTN US~WABD mTWABD (2)NSS'`SSeTvS mTWlZ$' '>''@'I6&3'R ~S'`SS vpe

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