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DEHYDRATION
Dehydration
is the excessive loss of water from body tissues accompanied by an imbalance in essential electrolytes, such as sodium, potassium, and chloride. It occurs when the amount of water leaving the body is greater than the amount being taken in. The body is very dynamic and always changing.
Total
body water also varies in relation to age, gender, and amount of body fat. Adult males have approximately 60% water content, adult females have 50%, infants have an estimated 77%, and the elderly have 46% to 52%. An increase in body fat causes a decrease in the percent fluid content because fat does not contain significant amounts of water.
Hypertonic
of water.
Isotonic
when the body has lost about 2% of its total fluid. when the total fluid loss reaches
Moderate
5%.
Severe
CAUSES:
Diarrhea
Vomiting
Sweat Diabetes Inability Burns
to drink fluids
Mouth The eyes stop making tears Sweating may stop Muscle Cramps Nausea & Vomiting Heart Palpitations Light headedness (especially when standing) Weakness Decreased urine output
COMPLICATIONS:
Kidney Coma Shock
failure
Heat-related
Body weight
10 pounds
20 pounds 30 pounds
15 ounces
30 ounces 40 ounces
40 pounds
50 pounds 75 pounds
45 ounces
50 ounces 55 ounces
100 pounds
150 pounds 200 pounds
50 ounces
65 ounces 70 ounces
THE HEALTH CARE PRACTITIONER'S EXAMINATION OF THE PATIENT WILL ASSESS THE LEVEL OF DEHYDRATION. INITIAL
EVALUATIONS MAY INCLUDE:
Mental status tests to evaluate whether the patient is awake, alert, and oriented. Infants and children may appear listless and have whiny cries and decreased muscle tone. Vital signs may include postural readings (blood pressure and pulse rate are taken lying down and standing). Temperature may be measured to assess fever. Skin may be checked to see if sweat is present and to assess the degree of elasticity (turgor) The mouth can become dry and the health care practitioner may look or feel the tongue for fluid.
Infants may have additional evaluations performed, including checking for a soft spot on the skull (sunken fontanel). Pediatric patients are often weighed during routine child visits, thus a body weight measurement may be helpful in assessing how much water has been lost with the acute illness. Laboratory testing The purpose of blood tests is to assess potential electrolytes abnormalities (including sodium, potassium, and chloride levels) associated with the dehydration. Urinalysis may be ordered to determine urine concentration, the more concentrated the urine, the more dehydrated the patient.
TREATMENT:
Drinking fluids is usually enough for mild dehydration. It is better to drink small amounts of fluid often instead of trying to force large amounts of fluid at one time.
Do not drink coffee, colas, or other drinks that contain caffeine. They increase urine output and make you dehydrate faster.
Provide frequent, oral care. Wear cotton made shirts to prevent sweating.
Loperamide
(Imodium) may be considered to control diarrhea. If the affected individual has a fever, or if there is blood in the diarrhea, medical advice should be obtained before administering medications to control diarrhea. or ibuprofen may be used to
Acetaminophen
control fever.
Avoid
alcohol consumption, especially when it is very hot, because alcohol increases water loss and impairs your ability to recognize early signs associated with dehydration.
PROGNOSIS:
Rapid
recognition and treatment of dehydration will result in a successful outcome. In the absence of complications, fluid balance is usually restored. If not treated quickly, severe dehydration can result in cardiovascular collapse, seizures, permanent brain damage, or death.
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