the urine to prevent toxic levels in the serum. There are a variety of risk factors for the development of the refeeding syndrome. Hyponatremia is a relative contraindication to the use of hypotonic intravenous fluids and hypernatremia calls for the administration of water. ... A positive fluid balance is known to be associated with higher mortality and morbidity among ICU patients [24]. Na and, protein intake is proportionately related to Ca excretion in, P content of dietary protein augments this hypercalciuric, effect of proteins. In adults, the capillary refill time and poor skin turgor have no proven diagnostic value. Mg absorption is primarily regulated by GI and renal. Increased thirst, fatigue, restlessness, muscle. Structured telephone interviews were conducted to assess patients’ satisfaction. Access scientific knowledge from anywhere. losses, chronic alcohol abuse, and hyperaldosteronism. En 2003, un groupe de travail de la Société Française de Pharmacie Clinique (SFPC) a mis au point un outil codifiant les interventions relatives aux problèmes médicamenteux détectés au cours de l'analyse de prescription par les pharmaciens ainsi qu'une base de données (ACT-IP©) destinée à la collecte de ces interventions. A fluid and electrolyte management plan developed by a multidisciplinary team is advantageous in promoting continuity of care and producing safe outcomes. Thirty-eight semi-structured interviews were undertaken with GPs, district nurses, Macmillan nurses, and framework facilitators. the intracellular K content, which leads to hyperkalemia. The aim of this review is to equip general surgery trainees with the essentials of RFS including a review of the National Institute for Health and Care Excellence (NICE) best practice guidelines for RFS. Knowledge of the risk factors and the clinical signs of the refeeding syndrome is important to optimize outcomes. Conclusions: Pharmaceutical interventions can adjust unreasonable prescriptions and modify errors. disorders in adult patients in the intensive care unit. Case reports and case series continue to be reported, suggesting that this entity continues to exist in critically ill patients. ments for an adult with normal renal function. factors drive aldosterone secretion, the effect of serum K. levels on aldosterone secretion is significant. All formulae regard the patient as a closed system, and none takes into account ongoing fluid losses that are highly variable between patients. of the complexity of collecting urinary samples. Received for publication July 23, 2011; accepted for publication. Background: The optimal rate of feeding advancement after initiation of early ent-eral nutrition (EEN) for underweight, critically ill patients is unknown. Overall rates of first outpatient attendances declined more strongly for pilot practices than controls. framework influences interprofessional relationships and communication, and to compare GPs' and nurses' experiences. Fluid and Electrolyte Management Billie Bartel and Elizabeth Gau Le a r n i n g Objectives 1. These aspects of palliative care are highlighted in the Gold Standards Framework, a programme recently established in UK primary care. Le travail se décline en quatre séquences : 1. quantifier le savoir nécessaire pour prescrire et dispenser des médicaments 2. déconstruire ce contenu afin de rapporter de quoi une intervention pharmaceutique est le résultat 3. rechercher ce qui normalement aurait dû y être présent et qui est absent 4. dessiner les sujets de recherche à venir. Medications that could be contributing to, decreased urinary K excretion (eg, spironolactone, non. Ca levels target the parathyroid gland to, either increase or decrease production of PTH, which in, turn drives intestinal absorption of Ca, renal absorption/, excretion of phosphorus (P) and Ca, and bone mobiliza, PTH also converts the inactive form of vita. absorption from the human rectum and distal colon. Nausea, vomiting, headache, muscle cramps, 1. The assessment of Ca status must include an evalua, tion of P and Mg status, in addition to PTH and vitamin. Regardless of dietary content, absorp. ence of a normal albumin level, as a serum Ca <8.5 mg/, dL. Symptomatic or severe hypomagnesemia (<1 mg/dL), should be replaced with 32–64 mEq of IV Mg. and increased demand of Mg for anabolism. Many equations are available to aid clinicians in providing safe, recommendations or at least to give a starting point for correct. The aim of this study was to establish if the indications for prescribing PN in a tertiary children’s hospital were appropriate, and to identify complications encountered. The prescriptions of total parenteral nutrition in our hospital from January 1st, 2013 to December 31st, 2013 were retrospectively analyzed. Thus, therapy of severe hyponatremia and hypernatremia must be closely monitored with serial electrolyte measurements. balance, including how and why it should be measured, and discusses the importance of accurate fluid balance measurements. regulatory mechanism of each electrolyte. Address correspondence to: Kristen M. Rhoda, MS, RD, CNSD, Human Nutrition, Cleveland Clinic, 9500 Euclid. PN-dependent individuals, with adjustments as needed. Although the indications for inpatient PN in children is mostly justified, there is still a proportion who is receiving PN unnecessarily.