f. Bleeding. Bleeding of any amount produces loss of plasma, red blood cells,
and other dissolved substances. The effect of the loss becomes greater as the amount
g. Diuretic Drugs. A person who is being treated with thiazide diuretics also
loses fluids and electrolytes (primarily potassium). In such cases, potassium must be
given to the patient to prevent potassium deficiencies.
2-12. REPLACING ABNORMAL FLUID LOSS
When fluid and electrolyte loss becomes abnormal, the medical specialist, the
physician assistant, or the physician has two means of correcting the fluid and
electrolyte balance--oral (by mouth) and intravenous.
a. Oral Route. The safest route is oral. For example, a person on thiazide
diuretics may be given orange juice or tablets to replace the potassium needed. This is
the preferred route since the patient is able to move freely and the psychological
problems of intravenous administration are not present.
b. Intravenous Route. The intravenous route makes it possible to control the
volume of fluid and the numbers of electrolytes to be given. Infection can be caused by
a contaminated intravenous solution, administration set, or administration site. This will
complicate the recovery of an already ill or injured patient. Another consideration is the
total volume of fluid to be administered to the patient over a given time period.
Generally, an adult patient should not receive more than four liters (4,000 milliliters) of
intravenous fluid over a 24-hour period. A careful record must be kept of the volume of
fluid administered since this must be taken into account when calculating a patient's
fluid intake and output. The renal condition of the patient also affects the volume of
intravenous solution to be administered. When the patient has impaired kidney
function, you must be very careful not to overload the patient's system.
An enzyme is a complex biological catalyst. Most reactions, which are aided by
catalysts in the body, would take place without the enzyme, but too slowly to support
life. Enzymes speed up chemical reactions during which complex substances are
broken down into simple substances. The enzymes also speed the assembly of simple
substances into complex substances. The enzyme is a protein that is not consumed or
used up during its action as a catalyst. In the presence of an enzyme, a reaction uses
up less energy for its completion. Most enzymes have the suffix "ase" in their name.
This suffix is combined with the chemical name of the substance that uses the enzyme
as a catalyst. Enzymes that split starch (amylum) are called "amylase" and those that
react with fat (lipid) are called "lipase." Most others are named in a similar manner.