1.DEHYDRATION slides in Paediatrics site.pptx

Dehydration in Paed

1. DEHYDRATION DR MUMBERE MAYANI DAVID Inbox Orata Donald @0778370011 for hard copies. 1

2. CONTENT Definition Types Signs and symptoms Differential diagnosis Tests Treatment Inbox Orata Donald @0778370011 for hard copies. 2

3. Definition Dehydration occurs when the body loses more fluid than in take. When the normal water content of the body is reduced, it upsets the balance of minerals(salts and sugar) in the body, which affects the way it functions. Water makes up over two-thirds of the healthy human body. Inbox Orata Donald @0778370011 for hard copies. 3

4. … It lubricates the joints and eyes, aids digestion, flushes out waste and toxins, and keeps the skin healthy. Inbox Orata Donald @0778370011 for hard copies. 4

5. Types There are 3 types of dehydration: Hypotonic or hyponatremic (primarily a loss of electrolytes, sodium particularly), Hypertonic or hypernatremic (primarily a loss of water ) and Isotonic or isonatremic (equal loss of water and electrolytes). Inbox Orata Donald @0778370011 for hard copies. 5

6. Signs & symptoms May include headache similar to what is experienced during a hangover A sudden episode of visual snow Dizziness or fainting when standing up due to orthostatic hypotension Untreated dehydration generally results in delirium, unconsciousness, swelling of the tongue and , in extreme cases death. Inbox Orata Donald @0778370011 for hard copies. 6

7. Signs & symptoms Thirst Dryness of mucous membranes Loss of skin turgor Orthostatic hypotension or tachycardia Reduced jugular venous pressure ( jvp ) or central venous pressure ( cvp ) Decreased urine output Inbox Orata Donald @0778370011 for hard copies. 7

8. Inbox Orata Donald @0778370011 for hard copies. 8

9. DD In human dehydration can be caused by a wide range of diseases and states that impair water homeostasis in the body. These include: Extra renal or stress related causes Prolonged physical activity with sweating without consumming adequate water , especially in a hot and /or dry environment Inbox Orata Donald @0778370011 for hard copies. 9

10. … Blood loss or hypotension due to physical trauma Diarrhea Hyperthermia Shock (hypovolemic) Vomiting Burns Inbox Orata Donald @0778370011 for hard copies. 10

11. … Lacrimation Use of methamphetamine, amphetamine, amphetamine, caffeine and other stimulants. Excessive consumption of alcohol beverages Inbox Orata Donald @0778370011 for hard copies. 11

12. … b. Malnutrition Electrolyte disturbance Hypernatremia ( also caused by dehydration) Hyponatremia , especially from restricted salt diets Fasting Inbox Orata Donald @0778370011 for hard copies. 12

13. … Recent rapid weight loss may reflect progressive depletion of fluid volume (the loss of 1 L of fluid results in a weight loss of 1 kg(2.2 ib )) Patient refusal of nutrition and hydration Inability to swallow (obstruction of the esophagus) Inbox Orata Donald @0778370011 for hard copies. 13

14. … C. Infectious Diseases Cholera Gastroenteritis Shigellosis Yellow fever Inbox Orata Donald @0778370011 for hard copies. 14

15. … d. Other causes of obligate water loss Severe hyperglycemia, especially in Diabetes mellitus Glycosuria Uremia Diabetes insipidus Acute emergency dehydration event Food borne illness Inbox Orata Donald @0778370011 for hard copies. 15

16. Tests Blood chemistries (to check electrolytes, especially sodium, potassium, and bicarbonate levels) Blood urea nitrogen (BUN) Complete blood count (CBC) Creatinine Urine specific gravity Inbox Orata Donald @0778370011 for hard copies. 16

17. … Other tests may be done to determine the cause of the dehydration (for example , blood sugar level to check for diabetes) Inbox Orata Donald @0778370011 for hard copies. 17

18. Treatment Mild-to-moderate volume depletion (often due to gastroenteritis) should be corrected by increasing oral intake of sodium and water by an oral rehydration solution. • In severe volume depletion, administer intravenous fluids (normal saline or Ringer’s lactate). Inbox Orata Donald @0778370011 for hard copies. 18

19. Treatment For some dehydration oral fluid is the most effective to replenish fluid deficit. In more severe cases, correction of fluid deficit is best by intravenous therapy. Solutions used for intravenous rehydration must be isotonic or hypotonic. For severe cases of dehydration where fainting , unconsciousness, or other severely inhibiting symptom is present ( the patient is incapable of standing or thinking clearly), Inbox Orata Donald @0778370011 for hard copies. 19

20. … , emergency attention is required. Fluids containing a proper balance or replacement electrolytes are given intravenously with continuing assessment of electrolyte status. Inbox Orata Donald @0778370011 for hard copies. 20