dehydration

1. UNIT-VIII
FLUID AND ELECTROLYTE
DEFICIT

2. A condition that
results from illness ; a hot, dry
climate; prolonged exposure to sun or
high temperatures; not drinking
enough water; and overuse of diuretics
or other medications that increase
urination?

4. DEHYDRATION
Dehydration is a condition that occurs when the body
loses too much water and other fluids that it needs to
work normally.
It occurs when more water and fluids leave the body than
it enter.
Dehydration can be defined as when the loss of water and
salts is more than is replenished.
The average person loses about 2.5 liters of water every
day. So to stay properly hydrated you must replenish
this water in order to keep from being dehydrated.

5. LOSS CAN :
1. Mild : loss to 1 to 2 L of water (2% body
weight is lost)
2. Moderate : Loss to 3 to 5 L of water (5%
body weight is lost)
3. Severe : Loss of 5 to 10 L of water (8% of
body weight is lost)

6. CAUSES AND RISK FACTOR
Causes:
Not drinking water Physical exercise Sweat excessively
Fever Vomiting Frequent urination
Kidney Failure Burns High level of glucose
Diarrhea Use of Diuretics Drinking too much alcohol

7. PEOPLE AT RISK :
1. Babies and infants :
They have low body weight and are sensitive to
very small amount of fluid loss.
2. Older people:
They may be less aware that they are becoming
dehydrated and need to keep drinking water.
3. People with chronic illness
4. People who work / exercise: Athletes

8. CLINICAL MANIFESTATIONS OF
DEHYDRATION
Feeling thirsty Dry mouth Less frequent
urination
Dizziness
Dark color urine Dry skin Feeling tired Lethargic
Fainting Confusion Reduced skin
elasticity
Muscle cramps
Light headedness Fast heart rate Fast breathing Irritability

10. SIGNS OF MILD DEHYDRATION

12. ORAL REHYDRATION SALT
(ORS)
• What are the constituents?
The composition of the new, reduced osmolarity
ORS, as recommended by WHO, is as follows:
• Sodium chloride—2.6 g
• Glucose (anhydrous)—13.5 g
• Potassium chloride—1.5 g
• Trisodium citrate dehydrate—2.9 g
(Total weight of a packet = 20.5 g)
The new ORS was launched by WHO in January
2004 and in India in June 2004.

13. • How is the ORS reconstituted?
The contents of the packet are dissolved in 1 L
of drinking water.
• What is the role of each of the constituents?
• Glucose facilitates absorption of sodium and
hence water.
• Sodium and potassium replace the loss of
these essential elements in diarrhea and
vomiting.

14. • What is the indication?
Mild and moderate dehydration
• What are the instructions given regarding
reconstitution?
• Dissolve the entire content of the packet in 1 L
of clean drinking water.
• The prepared solution should be used within 24
hours. Discard the solution left after 24 hours.
• The solution should be made fresh daily.
• It should not be boiled or sterilized otherwise.

15. • How will you manage when these packets are
not available?
If this mixture is not available, a simple sugar
and salt solution can be prepared as follows:
• Table salt—5 g
• Sugar—20 g
• Water—1 L
Dissolve the salt and sugar in 1 L of water.

17. DIAGNOSTIC EVALUATION
1. History collection
2. Physical examination
• { vital signs}
• {Capilary refill time}
• { Poor Skin Turgor}
3. Complete blood count

18. MEDICAL MANAGEMENT
Initial evaluations may include:
1. Mental status tests to evaluate whether the
patient is awake, alert, and oriented.
2. Vital sign assessments may include postural
readings (blood pressure and pulse rate are
taken lying down and standing). With
dehydration, the pulse rate may increase and
the blood pressure may drop because the
intravascular space is depleted of water.

19. • 3. Temperature may be measured to assess
fever.
• Skin will be checked to see if sweat is present
and to assess the degree of elasticity. As
dehydration progresses, the skin loses its water
content and becomes less elastic

20. NURSING MANAGEMENT
1. Urge the patient to drink the prescribed amount
of fluid.
Oral fluid replacement is indicated for mild fluid
deficit and is a cost-effective method for
replacement treatment.
Older patients have a decreased sense of thirst and
may need ongoing reminders to drink.
2. Monitor and document vital signs, especially BP
and HR. A decrease in circulating blood volume
can cause hypotension and tachycardia. Alteration
in HR is a compensatory

21. Assess skin turgor and oral mucous membranes for signs
of dehydration. Signs of dehydration are also detected
through the skin. The skin of elderly patient’s losses
elasticity; hence skin turgor should be assessed over the
sternum or on the inner thighs.
4. Assess color and amount of urine. Report urine output
less than 30 ml/hr for two (2) consecutive hours.
Normal urine output is considered normal, not less than
30ml/hour. Concentrated urine denotes fluid deficit.
5. Monitor fluid status in relation to dietary intake. Most
fluid comes into the body through drinking, water in
food, and water formed by the oxidation of foods.
Verifying if the patient is on a fluid restraint is
necessary

22. COMPLICATIONS:
Untreated Severe dehydration
• Death
• Permanent brain damage
• Seizures

23. NURSING DIAGNOSIS
Fluid volume deficit related to insufficient
fluid intake as evidenced by Decreased urine
output.

24. THANK YOU