Dehydration

Dehydration is defined as the excessive loss of body fluid.

1. DEHYDRATION BY NATASHA PURI

2. WHAT IS DEHYDRATION? TYPES OF DEHYDRATION SIGNS AND SYMPTOMS DIFFERENTIAL DIAGNOSIS TESTS TREATMENT CONTENT

3. Dehydration occurs when your body loses more fluid than you take in. When the normal water content of your body is reduced, it upsets the balance of minerals (salts and sugar) in your body, which affects the way it functions. Water makes up over two-thirds of the healthy human body. It lubricates the joints and eyes, aids digestion, flushes out waste and toxins, and keeps the skin healthy. What is Dehydration?

4. There are three types of dehydration: a. Hypotonic or hyponatremic (primarily a loss of electrolytes, sodium in particular ), b. Hypertonic or hypernatremic (primarily a loss of water), and c. Isotonic or isonatremic (equal loss of water and electrolytes). Types of Dehydration

5. May include headaches 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 . Signs

6. Thirst Dryness of mucous membrane Loss of skin turgor O rthostatic hypotension or tachycardia R educed jugular venous pressure(JVP) or central venous pressure(CVP ) Decreased urine output Symptoms

7. In humans, dehydration can be caused by a wide range of diseases and states that impair water homeostasis in the body. These include:  a. External or stress-related causes Prolonged physical activity with sweating without consuming adequate water, especially in a hot and/or dry environment Blood loss or hypotension due to physical trauma Diarrhea Hyperthermia Shock( hypovolemic ) Vomiting Burns Lacrimation Use of methamphetamine, amphetamine, caffeine and other stimulants Excessive consumption of alcoholic beverages Differential Diagnosis

8. b . Malnutrition Electrolyte disturbance Hypernatremia (also caused by dehydration) Hypernatremia, especially from restricted salt diets Fasting Recent rapid weight loss may reflect progressive depletion of fluid volume (the loss of 1 L of fluid results in a weight loss of 1kg (2.2lb)). Patient refusal of nutrition and hydration Inability to swallow (obstruction of the esophagus) Differential Diagnosis

9. c . Infectious Disease Cholera Gastroenteritis Shigellosis Yellow fever Differential Diagnosis

10. d. Other causes of obligate water loss Severe hyperglycemia, especially in diabetes mellitus - Glycosuria - Uremia Diabetes insipidus Acute emergency dehydration event Food borne illness Differential Diagnosis

11. Blood chemistries(to check electrolytes, especially sodium, potassium, and bicarbonate levels) Blood urea nitrogen(BUN) Complete blood count(CBC) Creatinine Urine specific gravity Other tests may be done to determine the cause of the dehydration (for example, blood sugar level to check for diabetes Tests

12. 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), emergency attention is required. Fluids containing a proper balance of replacement electrolytes are given intravenously with continuing assessment of electrolyte status. Treatment