Body fluid and salt metamoblism

Body fluid and salt metamoblism There are several causes underlying dysnatremia. Most significantly are both the management of dysnatremia and parenteral hydration. In normal status, the normal range of blood sodium concentrations are of 135-145 mmol/L. Sodium and its accompanying anions, which are mainly chloride and bicarbonate, represent for 90% of the extracellular effective osmolality. The plasma water content is a main determinant of the sodium concentration. Dysnatremias may have result in central nervous system dysfunction whereas hyponatremia may lead to brain swelling and hypernatremia may lead to brain shrinkage. According to the extracellular fluid volume status the hyoponatremia is classified as either hypovolemic or normo-hypervolemic. In children, vasopressin release is triggered by the low effective arterial blood volume in case of hypovolemic hyponatremia this is called syndrome of appropriate anti-diuresis. The primary defect in dilutional hyponatremia is euvolemic also there is inappropriate increase in circulating vasopressin levels this is called syndrome of inappropriate anti-diuresis. To determine presence of hyponatremia may shows obvious cause such as vomiting or diarrhea. In some status, to discriminate hypovolemic from normo- hypervolemic hyponatremia may not be obvious. Some patients have difficult to assess their status volume but there is helpful way to assess their status by detect urine spot sodium and the fractional sodium clearance. In state of normovolemic, the major defense against developing hyponatremia is the ability to dilute urine and excrete free-water. There are special causes lead to hypotonic hyponatremia which are hospital-acquired hyponatremia, desmopressin, endurance athlete and diuretics. Hypernatremia is a net water Loss or a hypertonic sodium gain, with Inevitable hypertonicity reflects hypernatremia. If sodium concentrations above 160 Mmol/ L are usually sever symptoms evident only with presence of acute and large increases in concentrations. Almost the cause of hypernatremia is always obvious from the history. If the cause is not evident, determine of urine osmolality in relation to the effective blood osmolality and the urine sodium concentration. There are two mechanisms prevent developing hypernatremia which are: release vasopressin and a powerful thirst mechanism. When the effective blood osmolality exceeds 275-280 mosmol/ kg H2o, release of vasopressin occurs and when the effective blood osmolality exceeds 290-295 mosmol/kg H2o that results in maximally concentrated urine. There are two causes of hypernatremia in outpatient which are breastfeeding and diarrhea or vomiting . In breastfeeding the major problem is water deficiency that cause sodium concentration raises as a result of low volume intake and a loss of water. Diarrhea or vomiting comparison to the past is less because of presumably to the advent of low solute infant formulas and the increased use and availability of oral rehydration solutions. In management of hyponatremia, used either V2 antidiuretic hormone receptor antagonists or urea. In fasting patients, Intravenous maintenance fluids done by Holliday are used to provide water and electrolyte requirements. used administer intravenous isotonic (or near isotonic) crystalloid solutions in children who resistant to initial oral rehydration therapy. Traditionally, mange chronic normovolemic (or hypervolemic) hyponatremia either by restricting water intake or by giving salt. May be the use of nonpeptide vasopressin receptor antagonists as alternative. There are several receptors for vasopressin which are v1a, V1b and v2receptors. In patients who have nephrogenic syndrome of inappropriate childhood anti-diuresis the vaptans do not correct hyponatremia. In these cases, use oral administration of urea. All in all, pediatricians must aware of the changing epidemiology of dysnatremia . Also, the hydrated parenterally with the hypotonic solutions which recommended by Holliday.

Case analysis Coursework Example | Topics and Well Written Essays - 250 words

Case analysis - Coursework Example 2 According to Thomas Hobbes, you should not destroy the revised will. This is because for Hobbes, morally right actions are the actions that are consistent with the law of nature. According to Hobbes, the law of nature is discoverable by reason, and all of us are able to discover it if we reason well. For Hobbes, the law of nature guides all of us and it is the law that enables us to know the morally good and the morally bad actions. In the case under consideration, you should not destroy the revised will because doing so is against the law of nature. This is because one of the precepts of the law of nature is to be honest and to tell the truth. 3 According to Kant, you should not destroy the revised will. This is because for Kant, in is categorical imperative, Kant says that in making moral decisions, we should always choose actions that we would wish to be made into universal laws; in other words, Kant states that in making moral decisions, we should choose actions that we would wish anybody in the same situation, and under the same circumstances, to make (Kant, 18). For this reason, since one would not wish his or her own will to be destroyed when we die, one should destroy another person’s will. Destroying the revised will for Kant, therefore, is morally wrong. 4 Of the above three philosophers, Kant is the philosopher who provides the best, and the most convincing account of what one should do in this case. This is because Kant gives a clear formula of making a moral judgement, i.e. in making moral decisions, act in a manner that you would wish all people in the same situation to act. Plato’s and Hobbes’ account of how one should act in this case are a bit unclear and unconvincing. This is because for Plato, it is not easy to determine an action that is virtuous and that promotes eudaimonia; For Hobbes, also, it is not easy to

Nihilism and its Relationship to the Death of God Essay

Nihilism and its Relationship to the Death of God - Essay Example Nihilism represents a philosophy of negation for all forms aestheticism. Friedrich Nietzsche wrote a great deal of literature concerning nihilism; however, critics argue that Nietzsche did not advocate nihilism, but he was concerned about the effects of nihilism on society and culture. The fundamental basis of nihilism constitutes the entire rejection of both social sciences and classical philosophical systems. Nihilism advocated utilitarianism and scientific rationalism. Utilitarianism is a moral framework that proposes doing the greatest good for the greatest number of people. Scientific rationalism deals with providing valid reasons to support arguments for them to be considered true. Nihilism aimed at negating all authority practiced by the state, church and family by representing a form of positivism and materialism comprising of a revolt against the established social order. Nihilists believed primarily on scientific truths for finding solutions to social problems; according to Nietzsche, science was the cure for all social problems since it eliminated ignorance that caused evil in societies. It is critical to understand the meaning and historical background of nihilism in order to recognize the relationship between nihilism and the death of God.