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isotonicdehydrationoccurswhenthefluidlostisisotonicwithserum,asinsweating,simpleenteritis,nephrosis.Therearethereforenoerrorsofelectrolytebalancelikelytoresult.Theconcentrationofsodiumisinthenormalrange.hypotonicdehydrationoccurswhenthereislossofbothsodiumandfluid.Theserumsodiumlevelfallsbelow135mmol/Landtheosmoticpressureofextracellularfluidislowerthannormal.hypertonicdehydrationAconditioncausedbytheexcessivelossofwaterfromthebody，whichthereislesselectrolytelossthanwater.Theserumsodiumlevelisover135mmol/Landtheosmoticpressureofextracellularfluidislowerthannormal.waterintoxication/dilutionalhyponatremiaanincreaseinthevolumeoffreewaterinthebody.Commoncausesareexcessiveingestionofwater,increasedinfusionsofhypotonicIVsolutions,orexcesssecretionsofantidiuretichormone(ADH).Clinicalmanifestationsareabdominalcramps,nausea,vomiting,lethargy,anddizziness.Itcanpotentiallyleadtoconvulsionsandcoma.hypokalemiaanabnormallylowserumpotassiumlevel(3.5mmol/L).Hypokalemiamayoccurinmetabolicalkalosis,chronicdiarrhea,Cushingsyndrome,primaryaldosteronism,andexcessiveuseofcortisone,orACTH.hyperkalemiaabnormallyhighpotassiumconcentrationintheblood(above5.5mmol/L),mostoftenduetodefectiverenalexcretion,asinkidneydisease,severeandextensiveburns,intestinalobstruction,diabetesmellitus,acuterenalfailureandhypoadrenocorticism.metabolicacidosisDecreasedpH(below7.35)andbicarbonateconcentrationofthebodyfluidscausedeitherbytheaccumulationofexcessacidsstrongerthancarbonicacidorbyabnormallossesofbicarbonatefromthebody.metabolicalkalosisAnincreaseinthealkalinityofbodyfluidsduetoanincreaseinalkaliintakeoradecreaseinacidconcentration,asfromvomiting.pHisover7.45.respiratoryacidosisAcidosisthatiscausedbyretentionofcarbondioxide,duetoinadequatepulmonaryventilationorhypoventilation,andthatresultsinadecreaseinbloodpHunlesscompensatedforbyrenalretentionofbicarbonate.respiratoryalkalosisanabnormalconditioncharacterizedbyahighplasmapH(over7.45)resultingfromincreasedalveolarventilation.Theconsequentaccelerationofcarbondioxideexcretionlowerstheplasmalevelofcarbonicacid,thusraisingplasmapH.Thehyperventilationmaybecausedbypulmonaryandnonpulmonaryproblems.Somepulmonarycausesareacuteasthma,pulmonaryvasculardisease,andpneumonia.Somenonpulmonarycausesareaspirintoxicity,anxiety,feveretc.acepsistheexclusionofallmicroorganismsbeforetheycanenteranopensurgicalwoundorcontaminateasterilefieldduringsurgerysterilizationtheprocessofdestroyingallmicroorganismsandtheirpathogenicproducts.Itisaccomplishedbyheat(wetsteamordryheat)orbybactericidalchemicalcompounds.disinfectionTheprocessoractofdestroyingpathogenicmicroorganisms.However,certainbacterialsporesmaysurviveandgerminatewhichcouldleadtocontamination.bloodtransfusiontheadministrationofwholebloodoracomponent,suchaspackedredcells,toreplacebloodlostthroughtrauma,surgery,ordisease,inordertosupplementbloodvolume,improvecirculatoryfunctionandoxygen-carryingability,increasetheplasmaproteinandenhanceimmunityandcoagulationfunction.hematocritHCTameasureofthepackedcellvolumeofredcells,expressedasapercentageofthetotalbloodvolume.Thenormalrangeisbetween43%and49%inmenandbetween37%and43%inwomen.tansfusionreactionagroupofclinicalsignsduetoantibodyintherecipient'sbloodreactingwiththetransfusedredbloodcellswhenbloodfortransfusionisincorrectlymatched,orwhentherecipienthasanadversereactiontosomeelementofthedonorblood.SIRSaninflammatorystateaffectingthewholebody,frequentlyaresponseoftheimmunesystemtoinfection,butnotnecessarilyso.Itisrelatedtosepsis,aconditioninwhichindividualsbothmeetcriteriaforSIRSandhaveaknownorhighlysuspectedinfection.Temperature36oCor38oCHeartrate90beats/minRespiratoryratepCO232mmHgor20breaths/minWBCcount4x109or12x109or,orthepresenceof0.10immatureneutrophilstransfusion-relatedacutelunginjuryTRALIasyndromeseeninpersonsreceivingtransfusions,characterizedbypulmonaryedema,dyspnea,hypoxemia,hypotension,andfever;itisthoughttobeareactiontoantibodiesorothercomponentsofthedonorbloodproduct.Patientsneedoxygensupport,andinsomecasesthesyndromecanbefatal.transfusionassociatedgraftversushostdiseaseisararecomplicationofbloodtransfusion,inwhichthedonorTlymphocytesmountanimmuneresponseagainsttherecipient'slymphoidtissue.Donorlymphocytesareusuallyidentifiedasforeignanddestroyedbytherecipient'simmunesystem.However,insituationswheretherecipientisimmunocompromised,orwhenthedonorishomozygousandtherecipientisheterozygousforanHLAhaplotype,therecipient'simmunesystemisnotabletodestroythedonorlymphocytes.Thiscanresultingraftversushostdisease.autologousbloodtransfusion/autotransfusionInfusionofbloodorbloodproductsintotheindividualfromwhomtheywereoriginallywithdrawn.freshfrozenplasmaFFPanunconcentratedformofbloodplasmacontainingalloftheclottingfactorsexceptplatelets.Itcanbeusedtosupplementredbloodcellswhenwholebloodisnotavailableforexchangetransfusionortocorrectableedingproblemofunknowncause.Itisalsousedtocorrectdisseminatedintravascularcoagulation.freshplasmaFPaformofbloodplasmawhichisobtainedafterFFPismeltedat4℃andcryoprecipitateisremoved