alice - dehydration
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Cracked Lips: Sign of Dehydration
Cracked Lips
Dehydration describes a state of negative fluid balance that may be caused by numerous disease entities.
Diarrheal illnesses are the most common etiologies.
Worldwide, dehydration secondary to diarrheal illness is the leading cause of infant and child mortality.
Dehydration
Sign and Symptom of Dehydration
Isotonic/Isonatremic dehydration: water & electrolytes lost in equal proportions
Hypertonic/Hypernatremic dehydration: water loss exceeds electrolyte loss
Hypotonic/Hyponatremic dehydration: electrolyte loss exceeds water loss
Types of Dehydration
Isotonic: inadequate fluid intake, fluids shifts between compartments, excessive loss of body fluids
Hypertonic: excessive perspiration, hyperventilation, fever, diarrhea, Drinking sea water in attempt to treat dehydration
Hypotonic: chronic illness such as renal failure, Cystic fibrosis with excessive salt loss in sweat , Gastrointestinal obstruction, fistula, ileus
Dehydration Etiology
Level of Dehydration
Symptom/Sign Mild Dehydration Moderate Dehydration Severe Dehydration
level of consciousness
Alert Lethargic Obtunded
Capillary refill* 2 s 2-4 s >4 s, cool limbs
Mucous membranes Normal Dry Parched, cracked
Tears Normal Decreased Absent
Heart rate Slightly increased Increased Very increased
Respiratory rate/pattern*
Normal Increased Increased and hyperpnea
Blood pressure Normal Normal, but orthostasis
Decreased
Pulse Normal Thready Faint or impalpable
Skin turgor* Normal Slow Tenting
Fontanel Normal Depressed Sunken
Eyes Normal Sunken Very sunken
Urine output Decreased Oliguria Oliguria/anuria
* Best indicators of hydration status[6]
Pathogenesis of Dehydration
Loss of GI fluids (vomiting, diarrhea, NG suctioning, fistulas, intestinal drainage, chronic abuse of laxatives and/or enemas)
Renal loss from diuretics Water loss from sweating or heatBlood loss (hemorrhage)Fluid lost to Third Space (burns, trauma)
Pathophysiology of Dehydration
Dehydration can lead to heart shock, fainting even death
Higher blood viscosityHigher blood pressureBlood clotting
Takes water from the rest of body when thirsty
Toxins accumulateCannot be flushed out of bodyCan be damaged
ConstipationAcid RefluxIndigestion
Toxin Accumulate
Diet therapy Oral replacement therapy Oral Rehydration therapy
Drug therapy(varies with type of dehydration)
IV=isotonic(safest) 0.9% NaCl,Ringer’s Lactate (sln isotonic
with blood) Medicine to treat underlying problem
Treatment for Dehydration
Drink at least 8-12 cups of liquid each day Choose beverages that are caffeine free.Drink before you feel thirsty. By the time you feel thirsty, you are already dehydrated.
Prevention
http://www.nhs.uk/Conditions/Dehydration/Pages/Treatment.aspx
http://www.aboutkidshealth.ca/en/healthaz/conditionsanddiseases/symptoms/pages/dehydration.aspx
http://www.aurorahealthcare.org/fywb_pdfs/x14172.pdf
http://www.webmd.com/a-to-z-guides/dehydration-adults
http://emedicine.medscape.com/article/906999-overview
Reference
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