c.c. should be added to the daily fluid intake. Fluid requirement will
increase with the increase in the body surface area and the atmospheric
temperature and humidity (leading to increase in sweating). Fluids could
be given orally or (if not possible), it could be given intravenously.2- Electrolytes and acid-base balance:
- Prevent and treat hyperkalemia.
- Avoid hyponatremia.
- Keep serum bicarbonate above 16 mmol/L.
- Minimize hyperphosphatemia by giving phosphate binders (e.g. Ca
Co 3 & AL hydroxide) with meals. - Treat hypocalcaemia.
3- Nutritional support:
- Restrict protein (to 0.5gm/kg/day) but maintain sufficient caloric
intake. - Carbohydrate intake should be at least 100 gm/day to minimize
ketosis and endogenous protein catabolism.
4- Drugs:
- Review all medications.
- Stop magnesium-containing medications.
- Adjust dosage for renal failure.
5- Treatment of hyperkalemia:
- Calcium gluconate I.V. • Glucose 50% + Insulin
- Na Hco 3 I.V. • Salbutamol
- K-exchange resins (e.g. resonium) • Dialysis
- Avoid diets and drugs causing hyperkalaemia