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1.6: Dehydrations

Table of Contents

It refers to the loss of body water, with or without salt at a rate greater than the body can replace it. The cause of dehydration is a combination of physiological and disease processes. Persons at greatest risk for dehydration include persons with diarrhoea, vomiting, fever, diabetes or infections, impaired level status.

 

Table 1.2: Types of Dehydrations 

 

  Mild  Moderate Severe
Consciousness Is normal May be irritable but is conscious Unconscious
Skin pinched up Becomes normal immediately Takes two seconds for folds to disappear Remain in folds for over two seconds
Eyes Moist and tears are present Sunken, tears and absent Sunken and tearless
Mouth Not dry Is dry Is dry

 

Note: In Severe dehydration there is also oliguria

 

 

 

Investigations

  • Blood chemistry (to check electrolytes, especially sodium, potassium, and bicarbonate levels)
  • Blood urea nitrogen (BUN)
  • Full blood count (FBC)
  • 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).

 

Non-Pharmacological Treatment

The treatment for minor dehydration often considered the most effective, is drinking water and stopping fluid loss.

 

Pharmacological Treatment

In more severe cases, correction of a dehydrated state is accomplished by the replenishment of necessary water and electrolytes.

 

A: Oral Rehydration salt (ORS)

OR

A: IV 0.9% Sodium Chloride

OR

A: IV Ringers Lactate solution

 

If there is no electrolyte loss; give

A: IV Dextrose solution 5%

 

Note: If the underlying disease condition is diagnosed; treat as per specific condition in guidelines.

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