dehydration

• Dehydration


  Excessive loss of water from the body tissues
• Common disturbance in infants and children whenever total fluid output exceeds total fluid intake
• Categories of dehydration


  • Isotonic (isonatremic)
  • Hypertonic (hypernatremic)
  • Hypotonic (hyponatremic)
• Isotonic dehydration


  • Plasma osmolality normal
  • Serum Na* normal
  • H2O = Na
• Hypertonic dehydration


  • Plasma osmolality increase
  • Serum Na* increase
  • H2O < Na
• Hypotonic dehydration


  • Plasma osmolality decrease
  • Serum Na* decrease
  • H2O > Na
• Insensible water loss from skin and respiratory tract

  Increases (e.g. high fever, hyperventilation)
• Increased renal and GI fluid losses

  Increases (e.g. vomiting, diarrhea)
• Decreased fluid intake


  Decreases
• Dehydration


  • Increased heart rate (tachycardia)
  • Dry skin and mucous membrane
  • Sunken eyes and fontanelles
  • Decreased skin elasticity and turgor
  • Prolonged capillary refill (>2 sec)
  • Changing LOC (irritability to lethargy)
  • Altered response to stimuli
• Laboratory and diagnostic studies for dehydration

  • Urinalysis
  • CBC
  • Electrolyte Studies
  • BUN (over 17mg/dL)
  • Serum Bicarbonate (16-17mEq/L or mmol/L)
  • ABG
• Manage dehydration


  1. Restore and maintain adequate hydration

  2. Accurate I & O

  3. IVF

  4. Oral rehydration therapy

  5. Withhold full diet until well hydrated and problem is under control

  6. Gradually reintroduce to regular diet
• Medications for dehydration


  • Ondansetron (to decrease vomiting)
  • Zinc supplement (diarrhea)
  • Prebiotics (stimulate growth of probiotic bacteria to positively alter intestinal flora)
• categories