He aha ka Iron Dextran Injection: Nā hoʻohana, ka nui, nā hopena ʻaoʻao a me nā mea hou aku

ʻO ka Iron dextran injection he lāʻau lapaʻau e hāʻawi pololei i ka hao i loko o kou kahe koko ma o ka pana a i ʻole ka IV drip. Hiki i kāu kauka ke ʻōlelo aku i kēia lapaʻau ke loaʻa iā ʻoe ka anemia hemahema hao koʻikoʻi a ʻaʻole hiki ke komo pono i nā pila hao, a i ʻole ke pono ʻoe e hoʻihoʻi koke i nā pae hao no kou olakino a me kou maikaʻi.

He aha ka Iron Dextran?

ʻO ka Iron dextran he ʻano wai o ka hao i hui pū ʻia me ke kō i kapa ʻia ʻo dextran e kōkua i kou kino e ʻae i ka hao me ka palekana. E noʻonoʻo iā ia he mea hoʻohui hao i hoʻopaʻa ʻia e hele ana i kāu ʻōnaehana digestive holoʻokoʻa. Loaʻa i kēia ʻano injectable ka hao pololei i loko o kou kahe koko, kahi e hiki ai iā ia ke hoʻomaka koke e kōkua i kou kino e hana i nā ʻulaʻula koko olakino.

Hele mai ka lāʻau lapaʻau ma ke ʻano he wai ʻeleʻele ʻeleʻele e hāʻawi ai nā mea mālama ola i ka pana i loko o kou ʻiʻo a i ʻole ma o ka laina IV i loko o kou vein. Ua hoʻohana ʻia me ka palekana no nā makahiki he nui e mālama i nā poʻe e pono nui i ka hao akā ʻaʻole hiki ke loaʻa mai ka meaʻai a i ʻole nā mea hoʻohui waha wale nō.

No ke aha e hoʻohana ʻia ai ka Iron Dextran?

Hoʻomaʻamaʻa ka Iron dextran i ka anemia hemahema hao ke hana ʻole nā mea hoʻohui hao waha a ʻaʻole kūpono paha iā ʻoe. Kauoha kāu kauka i kēia ke haʻahaʻa loa nā hale kūʻai hao o kou kino e pono ai ʻoe i ka hoʻopiha koke ʻana e ʻoi aku ka maikaʻi a hana maʻamau.

Pono paha ʻoe i ka iron dextran inā ʻaʻole hiki iā ʻoe ke ʻae i nā pila hao no ka mea e hoʻopilikia nui lākou i kou ʻōpū. ʻIke kekahi poʻe i ka nausea nui, ka constipation, a i ʻole ka ʻeha o ka ʻōpū mai ka hao waha ʻaʻole hiki iā lākou ke hoʻomau i ka lawe ʻana i nā pila. I kēia mau hihia, lilo ka injection i mea ʻē aʻe no kāu ʻōnaehana digestive.

He pōmaikaʻi pinepine ka poʻe me kekahi mau maʻi olakino mai nā injections iron dextran. Inā loaʻa iā ʻoe ka maʻi kīkī maʻi, ka maʻi ʻōpū inflammatory, a i ʻole ua loaʻa iā ʻoe ke ʻoki ʻana i ka ʻōpū, hiki i kou kino ke hakakā e komo i ka hao mai ka meaʻai a i ʻole nā mea hoʻohui. Hōʻoia ka injection e loaʻa iā ʻoe ka hao āu e pono ai me ka nānā ʻole i nā pilikia o ka absorption.

Hiki i kāu kauka ke koho i ka iron dextran inā e nalowale ana ʻoe i ke koko ʻoi aku ka wikiwiki ma mua o ka hiki i nā mea hoʻohui waha ke pani i kāu waihona hao. Hiki kēia i kekahi manawa me nā manawa menstrual kaumaha, ke kahe koko i loko, a i ʻole i ka wā o ka hāpai ʻana i ka wā e piʻi nui ai kāu pono hao.

Pehea e hana ai ka Iron Dextran?

Hana ka iron dextran ma ka hāʻawi ʻana i ka hao pololei i loko o kou kahe koko, kahi e mālama ʻia ai i loko o kou ate, spleen, a me ka iwi iwi. Manaʻo ʻia kēia he lāʻau lapaʻau ikaika no ka mea e hoʻonui wikiwiki ia i kāu pae hao me ka ʻole o ka hilinaʻi ʻana i kāu ʻōnaehana digestive e komo iā ia.

I ka manawa i loko o kou kahe koko, e wāwahi mālie ka ʻāpana dextran o ka lāʻau, e hoʻokuʻu ana i ka hao no kou kino e hoʻohana. A laila hoʻohana kou iwi iwi i kēia hao e hana i nā ʻulaʻula koko olakino e hiki ke lawe i ka oxygen i loko o kou kino. Lawe pinepine kēia kaʻina hana i kekahi mau pule e hōʻike i nā hopena piha, ʻoiai e hoʻomaka ana kekahi poʻe e manaʻo i ka ikaika i loko o nā lā.

ʻOi aku ka ikaika o ka lāʻau lapaʻau ma mua o nā mea hoʻohui hao waha no ka mea e hāʻawi pololei ia i ka hao i kahi e pono ai kou kino. Eia naʻe, ʻaʻole ia he mea hoʻonāukiuki e like me ka hoʻoili koko, e lilo ia i koho lapaʻau waena no ka nele o ka hao.

Pehea wau e lawe ai i ka Iron Dextran?

Hāʻawi mau ʻia ka iron dextran e nā poʻe loea mālama ola i kahi hoʻonohonoho olakino, ʻaʻole loa ma ka home. E loaʻa iā ʻoe ma ke ʻano he injection i loko o kou ʻiʻo (ʻo ka maʻamau kou ʻūhā) a i ʻole ma o ka laina IV i loko o kahi vein i kou lima. Aia ke ʻano i ka nui o ka hao āu e pono ai a me ka makemake o kāu kauka.

Ma mua o kāu pahu, ʻaʻole pono ʻoe e pale i ka ʻai a i ʻole nā mea inu, akā e hōʻike i kāu hui mālama ola e pili ana i nā lāʻau lapaʻau āu e lawe nei. Manaʻo kekahi poʻe i ka ʻoluʻolu e ʻai i ka meaʻai māmā ma mua e pale ai i ka manaʻo ʻana i ka wili, ʻoiai ʻaʻole pono kēia. E hāʻawi paha kāu kauka iā ʻoe i kahi ana hoʻāʻo liʻiliʻi mua e hōʻoia ʻaʻole ʻoe i loaʻa i kahi hopena maʻi.

Lawe ka hana pahu maoli i kekahi mau minuke no ka pana ʻiʻo, a i ʻole a hiki i kekahi mau hola inā e loaʻa ana iā ʻoe ma o IV. Pono ʻoe e noho i loko o ka hale lapaʻau no ka liʻiliʻi o 30 mau minuke ma hope o ka loaʻa ʻana o ka pahu i hiki i nā limahana ke nānā iā ʻoe no nā hopena koke. He ana palekana maʻamau kēia manawa kali e kōkua i ka hōʻoia ʻana e maikaʻi ana ʻoe ma mua o ka hele ʻana i ka home.

Pehea ka lōʻihi e lawe ai au i ka Iron Dextran?

Loaʻa ka hapa nui o nā kānaka i ka iron dextran ma ke ʻano he lapaʻau hoʻokahi manawa a i ʻole he moʻo o nā pahu i loko o kekahi mau pule, ma mua o ka lawe ʻana iā ia i nā manawa a pau e like me ka lāʻau lapaʻau i kēlā me kēia lā. Hoʻoholo kāu kauka i ka papa manawa pololei e pili ana i ke koʻikoʻi o kāu hemahema hao a me ke ʻano o kou kino e pane ai i ka lapaʻau.

Pono paha ʻoe i hoʻokahi pahu inā he maʻalahi a i ʻole kaulike kāu hemahema hao. Eia naʻe, pono ka poʻe me ka anemia koʻikoʻi i nā pahu he nui i hohola ʻia ma luna o 2-4 mau pule e hoʻihoʻi piha i kā lākou pae hao. E nānā kāu kauka i kāu mau hoʻokolohua koko e ʻike i ka maikaʻi o ka hana ʻana o ka lapaʻau a me ka wā i loaʻa ai iā ʻoe ka hao lawa.

Ma hope o ka hoʻi ʻana o kāu pae hao i ka maʻamau, ʻaʻole pono ʻoe i nā pahu iron dextran hou ke ʻole e hoʻi mai kāu hemahema. Hiki i nā kānaka he nui ke mālama i kā lākou pae hao me nā loli meaʻai a i ʻole nā mea hoʻohui waha. E hoʻonohonoho kāu kauka i nā hoʻokolohua koko e hōʻoia i ka noho ʻana o kāu hao i nā pae olakino i ka wā lōʻihi.

He aha nā hopena ʻaoʻao o Iron Dextran?

Hiki i ka hao dextran ke hana i nā hopena ʻaoʻao, akā, ʻae ka hapa nui o nā kānaka iā ia ke hāʻawi ʻia e nā mea mālama ola i ʻike ʻia. He maʻalahi a he manawa pōkole nā hopena ʻaoʻao maʻamau, ʻoiai he kakaikahi nā hopena koʻikoʻi akā pono e mālama koke ʻia.

ʻO nā hopena ʻaoʻao maʻamau āu e ʻike ai, ʻo ia ka ʻeha a i ʻole ka ʻeha ma kahi i hoʻokomo ʻia ai ka lāʻau, ʻoi aku ka nui inā ua loaʻa iā ʻoe kahi injection muscle. Eia nā hopena maʻamau i ʻike ʻia e nā kānaka:

• ʻEha, pehu, a i ʻole ʻeha ma kahi i komo ai ka nila
• ʻO ka nausea maʻalahi a i ʻole ka ʻōpū
• ʻEha ke poʻo a i ʻole ka wili
• He ʻono metala i kou waha
• ʻEleʻele iki o kahi i hoʻokomo ʻia ai ka lāʻau
• ʻEha ʻiʻo a i ʻole ka ʻeha hui

ʻO kēia mau hopena ʻaoʻao maʻamau e pau i loko o kekahi mau lā a ʻaʻole pono e mālama kūikawā ma mua o ka hoʻomaha a me nā mea hōʻoluʻolu ʻeha ma luna o ka counter inā pono.

ʻO nā hopena ʻaoʻao koʻikoʻi akā ʻaʻole maʻamau e pono e mālama koke ʻia a me nā hopena maʻi maʻi koʻikoʻi. ʻOiai he mea maʻamau ʻole kēia mau hopena, nānā pono kāu hui mālama ola iā lākou:

• He paʻakikī ka hanu ʻana a i ʻole ka wheezing
• ʻEha ka umauma a i ʻole ka puʻuwai wikiwiki
• ʻO ka wili nui a i ʻole ka hāʻule
• ʻO ka ʻūlū ākea a i ʻole nā hives
• Pehu o ka maka, nā lehelehe, a i ʻole ka ʻāʻī
• ʻEha ʻōpū nui a i ʻole ka luaʻi

I kekahi manawa, hoʻomohala kekahi poʻe i nā hopena lohi i nā lā a i ʻole nā pule ma hope o ka injection, me ka ʻeha hui mau a i ʻole nā loli ʻili ma kahi i hoʻokomo ʻia ai ka lāʻau. Inā ʻike ʻoe i nā hōʻailona maʻamau ma hope o ka hele ʻana i ka home, e kelepona koke i kāu kauka.

ʻO wai ka mea ʻaʻole pono e lawe i ka hao Dextran?

ʻAʻole kūpono ka hao dextran no nā mea a pau, a e nānā pono kāu kauka i kāu mōʻaukala olakino ma mua o ka ʻōlelo ʻana i kēia lapaʻau. Pono nā kānaka me kekahi mau maʻi olakino a i ʻole nā kūlana e pale i ka hao dextran a i ʻole e loaʻa iā ia ma lalo o ka nānā kūikawā.

ʻAʻole pono ʻoe e loaʻa i ka iron dextran inā he nui loa ka hao i loko o kou kino, he maʻi i kapa ʻia ʻo ka iron overload a i ʻole hemochromatosis. ʻO ka lawe ʻana i ka hao keu ke loaʻa iā ʻoe nā mea nui loa hiki ke hōʻino i kou mau ʻōkana, ʻo kou ate a me kou puʻuwai. E nānā kāu kauka i kou pae hao me nā hoʻokolohua koko ma mua o ka mālama ʻana.

Hiki i nā poʻe me nā maʻi maʻi koʻikoʻi a i ʻole ka hānō ke kū i nā pilikia kiʻekiʻe me nā injections iron dextran. Inā ua loaʻa iā ʻoe nā hopena maʻi koʻikoʻi i nā lāʻau lapaʻau i ka wā ma mua, hiki i kāu kauka ke koho i kahi lapaʻau ʻē aʻe a i ʻole e hana i nā hana hou inā pono ka iron dextran no kou olakino.

Pono kekahi mau maʻi lapaʻau i ka noʻonoʻo kūikawā ma mua o ka hoʻohana ʻana i ka iron dextran. ʻAʻole e pale ʻokoʻa kēia mau kūlana iā ʻoe mai ka loaʻa ʻana o ka lapaʻau, akā pono lākou i ka nānā pono ʻana:

• Nā maʻi hana a i ʻole ke kuni
• Maʻi ate a i ʻole cirrhosis
• Maʻi puʻuwai a i ʻole ka puʻuwai i ka wā i hala
• Rheumatoid arthritis a i ʻole nā maʻi inflammatory ʻē aʻe
• Maʻi kīkī e koi ana i ka dialysis
• Mōʻaukala o nā maʻi koko

Inā hāpai ʻoe a i ʻole e hānai ana i ka waiū, e ana kāu kauka i nā pōmaikaʻi e kūʻē i nā pilikia hiki. ʻOiai hiki ke hoʻohana ʻia ka iron dextran i ka wā hāpai ke hana ʻole ka hao waha, ua mālama ʻia ia no nā kūlana kahi e ʻoi aku ai nā pōmaikaʻi ma mua o nā hopohopo.

Nā inoa inoa inoa Iron Dextran

Loaʻa ka iron dextran ma lalo o nā inoa inoa like ʻole, ʻoiai e hana like ka mana generic e like me nā koho branded. ʻO nā inoa inoa inoa maʻamau e pili ana iā INFeD a me Dexferrum, ʻo ia mau mea ʻelua i loaʻa ka mea hana like i nā ʻano like.

Hiki i kāu hale kūʻai lāʻau lapaʻau a i ʻole ka haukapila ke mālama i nā hōʻailona like ʻole, akā ʻaʻole kēia e pili i ka maikaʻi a i ʻole ka pono o kāu lapaʻau. Pono nā huahana iron dextran a pau e kū i nā kūlana palekana a me ka ikaika like, me ka nānā ʻole i ka mea hana. E koho kāu mea mālama ola i ka hōʻailona i loaʻa maʻalahi a kūpono no kāu mau pono.

Nā Koho ʻē aʻe o Iron Dextran

Nui nā koho ʻē aʻe i ka iron dextran inā ʻaʻole kūpono kēia lapaʻau iā ʻoe. Hiki i kāu kauka ke ʻōlelo aku i nā huahana hao injectable like ʻole e hana like akā he ʻokoʻa nā pilikia a i ʻole nā hopena ʻaoʻao.

ʻO ka iron sucrose a me ka ferric gluconate nā koho hao injectable hou e ʻae maikaʻi ai kekahi poʻe ma mua o ka iron dextran. ʻO kēia mau koho ʻē aʻe e hoʻoulu pinepine i nā hopena maʻi liʻiliʻi a palekana paha no ka poʻe me kekahi mau maʻi. Eia naʻe, pono lākou i nā mea liʻiliʻi he nui ma mua o hoʻokahi a ʻelua paha mau injections nui.

No ka poʻe hiki ke ʻae i nā lāʻau lapaʻau waha, ʻo nā mea hoʻohui hao kiʻekiʻe ka koho mua no ka mālama ʻana i ka hemahema o ka hao. ʻOiai lākou e hana lohi ana ma mua o nā injections, ʻoi aku ka palekana a me ka maʻalahi no ka hoʻohana lōʻihi. Hiki i kāu kauka ke hoʻāʻo i nā ʻano hao waha like ʻole a i ʻole e ʻōlelo aku e lawe iā lākou me kekahi mau meaʻai e hoʻomaikaʻi i ka absorption.

I nā hihia koʻikoʻi kahi i hana ʻole ai nā injections hao i ka wikiwiki, hiki i nā transfusions koko ke hoʻihoʻi wikiwiki i nā pae hao a me nā helu koko ʻulaʻula. Eia naʻe, lawe nā transfusions i kā lākou mau pilikia a mālama ʻia no nā kūlana pilikia a i ʻole i ka wā i hāʻule ai nā lapaʻau ʻē aʻe.

ʻOi aku ka maikaʻi o ka Iron Dextran ma mua o nā mea hoʻohui hao waha?

ʻAʻole pono ka iron dextran i ʻoi aku ka maikaʻi ma mua o nā mea hoʻohui hao waha, akā lawelawe ia i nā kumu like ʻole e pili ana i kāu kūlana. ʻO ke koho ma waena o ka hao injectable a me ka waha e pili ana i nā mea e like me ke koʻikoʻi o kāu hemahema, inā hiki iā ʻoe ke komo i nā lāʻau lapaʻau waha, a me ka wikiwiki o kāu pono i nā hopena.

He hana wikiwiki ʻo Iron dextran ma mua o nā mea hoʻohui waha no ka mea e pale loa ia i kāu ʻōnaehana digestive. ʻOiai hiki i ka hao waha ke lawe i kekahi mau mahina e hoʻihoʻi i kāu pae hao, hōʻike pinepine nā injections i nā hopena i loko o nā pule. ʻO kēia ka mea e lilo ai ka iron dextran i koho maikaʻi loa ke pono ʻoe i ka hoʻomaikaʻi wikiwiki ʻana i kāu waihona hao.

Eia naʻe, ʻoi aku ka palekana a me ka maʻalahi o nā mea hoʻohui hao waha no ka hapa nui o nā kānaka. ʻAʻole lākou e koi i nā kipa lapaʻau, lawe i nā pilikia haʻahaʻa o nā hopena maʻi maʻi koʻikoʻi, a ʻoi aku ka liʻiliʻi o ke kumukūʻai ma mua o nā lāʻau injectable. Inā hiki iā ʻoe ke ʻae i ka hao waha a ʻaʻole pono ʻoe i ka hoʻomaikaʻi wikiwiki ʻana, ʻo nā pills a i ʻole nā mea hoʻohui wai ka mea i makemake nui ʻia.

E hoʻāʻo mua kāu kauka i ka hao waha ke ʻole ʻoe he mau kumu kikoʻī no ke aha e hana ʻole ai nā pills iā ʻoe. Lilo ʻo Iron dextran i koho maikaʻi loa ke hana nā mea hoʻohui waha i nā hopena ʻaoʻao koʻikoʻi, ʻaʻole hiki i kou kino ke komo pono iā lākou, a i ʻole pono ʻoe i nā hopena wikiwiki no kou olakino a me kou maikaʻi.

Nā Nīnau i Nīnau Pinepine ʻia e pili ana i ka Iron Dextran

Q1. Palekana ʻo Iron Dextran no ka poʻe me ka maʻi puʻuwai?

Hiki ke hoʻohana ʻia ka iron dextran i ka poʻe me ka maʻi puʻuwai, akā pono ia i ka nānā pono ʻana a me ka noʻonoʻo ʻana e kāu hui mālama ola. E loiloi kāu kauka i kou kūlana puʻuwai kikoʻī a me ke olakino holoʻokoʻa ma mua o ka hoʻoholo ʻana inā kūpono ka iron dextran iā ʻoe.

Hiki i ka poʻe me ka maʻi puʻuwai ke pōmaikaʻi mai ka iron dextran inā loaʻa iā lākou ka anemia hemahema hao, no ka mea, hiki i nā pae hao haʻahaʻa ke hoʻonui i nā pilikia o ka puʻuwai ma ka hana ʻana i kou puʻuwai e hana ikaika e pauma i ke koko ʻilihuna oxygen. Eia naʻe, hiki i ke kaʻina hana injection ke hoʻopilikia i kou koko a me ka puʻuwai no ka manawa pōkole, no laila e nānā pono kāu hui lapaʻau iā ʻoe i ka wā a ma hope o ka mālama ʻana.

Q2. He aha kaʻu e hana ai inā loaʻa iaʻu ka nui o ka Iron Dextran?

Mai ka wā e hāʻawi mau ʻia ai ka iron dextran e nā poʻe loea olakino ma nā wahi lapaʻau i mālama ʻia, he mea kakaʻikahi loa ka loaʻa ʻana o ka overdose. Akā naʻe, inā manaʻo ʻoe ua loaʻa iā ʻoe ka nui o ka iron dextran a i ʻole e ʻike nei i nā hōʻailona koʻikoʻi ma hope o ka lapaʻau ʻana, e ʻimi koke i ka lāʻau lapaʻau.

ʻO nā hōʻailona e hōʻike ana ua loaʻa paha iā ʻoe ka nui o ka iron, e komo pū ana me ka nausea koʻikoʻi, ka luaʻi ʻana, ka ʻeha o ka ʻōpū, ka wili, a i ʻole ka pilikia o ka hanu ʻana. Mai hoʻāʻo e mālama i kēia mau hōʻailona ma ka home - akā, e hoʻokaʻaʻike koke i kāu kauka a i ʻole e hele i ka lumi pilikia kokoke loa. Hiki i nā poʻe loea olakino ke hāʻawi i nā lapaʻau e kōkua i kou kino e hana i ka iron keu me ka palekana.

Q3. He aha kaʻu e hana ai inā e hala wau i kahi mahele iron dextran i hoʻonohonoho ʻia?

Inā e hala ʻoe i kahi injection iron dextran i hoʻonohonoho ʻia, e hoʻokaʻaʻike i ke keʻena o kāu kauka i ka hiki wawe e hoʻonohonoho hou. Mai hopohopo - ʻaʻole e hoʻihoʻi nui ka hala ʻana i hoʻokahi mahele i kāu lapaʻau, akā he mea nui e hoʻi i ke ala me kāu papa hana i kauoha ʻia.

E hoʻoholo kāu hui mālama ola i ka manawa maikaʻi loa no kāu mahele makeup e pili ana i ka manawa āu i hala ai i ka manawa mua a me ke ʻano o ka pane ʻana o kou kino i ka lapaʻau. Hiki iā lākou ke hoʻoponopono i kāu mau mahele i koe a i ʻole e hoʻolōʻihi i kāu papa hana lapaʻau i kahi liʻiliʻi e hōʻoia ai e loaʻa iā ʻoe ka nui o ka iron e pono ai kou kino.

Q4. I ka manawa hea e hiki ai iaʻu ke hooki i ka lawe ʻana i ka iron dextran?

E hooki ʻoe i ka loaʻa ʻana o ka iron dextran ke hoʻoholo kāu kauka ua hoʻi hou kāu pae iron i nā pae maʻamau ma o nā hoʻokolohua koko. Hoʻopau ka hapa nui o nā kānaka i kā lākou lapaʻau iron dextran i loko o kekahi mau pule a i ʻole mau mahina, ma muli o ke koʻikoʻi o ko lākou hemahema i ka wā mua.

E hoʻonohonoho kāu kauka i nā hoʻokolohua koko e nānā i kāu pae hao a e hoʻoholo i ka manawa i loaʻa ai iā ʻoe ka lāʻau lawa. Ke hoʻopiha hou ʻia kāu waihona hao, ʻaʻole pono ʻoe i nā injections hou ke ʻole e hoʻi mai kāu hemahema. I kēlā manawa, hiki i kāu kauka ke ʻōlelo aku i nā mea hoʻohui hao waha a i ʻole nā loli meaʻai e mālama i nā pae hao olakino i ka wā lōʻihi.

Q5. Hiki iaʻu ke hoʻoikaika kino ma hope o ka loaʻa ʻana o Iron Dextran?

Maikaʻi nā hana māmā ma hope o ka loaʻa ʻana o ka hao dextran, akā pono ʻoe e pale i ka hoʻoikaika kino ikaika no ka liʻiliʻi o 24 mau hola ma hope o kāu injection. Pono kou kino i ka manawa e hana ai i ka hao a e ola mai ke kaʻina hana injection.

Inā loaʻa iā ʻoe ka injection i loko o kou ʻiʻo, ʻeha paha kēlā wahi no kekahi mau lā, e hōʻoluʻolu ʻole ai i ka hana kino ikaika. E hoʻolohe i kou kino a hoʻi mālie i kāu hana maʻamau i ka wā e ʻoi aku ai kou maikaʻi. Inā ʻike ʻoe i nā hōʻailona maʻamau i ka wā o ka hana, e hooki i ka hoʻoikaika kino a e hoʻokaʻaʻike i kāu mea mālama ola no ke alakaʻi.