Question

1. List ten potential causes of dehydration: 2. Which systems in the body depend on adequate hydration List five and explain your answers. System Role of Hydration 3. Why is dehydration so critical for humans? 4. List ten nursing assessment items which illuminate the client's hydration status. Think of history, comorbidities, and normal function of the body. 5. A client comes to the emergency room with a fever, nausea and vomiting, and dizziness a. How does each symptom relate to hydration and dehydration? b. List the top five nursing assessment items by priority below: c. Predict what will be done for this client, both medically and nursing-wise. List five treatment measures/interventions

Answer 1

Ans. 10 potential causes of dehydration:-

1.Diabetes insipidus

2. Interruption of neurologically driven thirst drive

3.Diabetic ketoacidosis

4.Osmotic Diuresis

5.Administration of hypertonic fluids

6. Poor oral fluid intake

7.Vomiting

8. Diarrhea

9. Haemorrhage

10. Excessive drainage (through colostomy, body cavity)

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Ans. 2

SYSTEM Role of hydration

i) Cardiovascular system. Blood pumping is the function of heart and its transportation to various body organs is the function vessels. Blood constitutes of plasma, blood cells; where plasma is majorly consists of water. If the water content is adequate the blood pressure will be maintained. If not, the blood pressure will increase and cause strain in heart. Thus, hydration plays an important role.

ii)Digestive system. The adequate hydration helps in easy passage of food from esophagus to stomach and stomach to intestine and then to rectum. If the adequate hydration is not present then it will cause pain in passage of stool and result in constipation.

iii)Excretory system.   ​​This system involves the excretion of waste in the form of urine from the body. The adequate hydration helps in maintaining proper pH of the urine. While poor hydration will result in concentrated urine.

iv) Nervous system. The brain and spinal cord both require adequate hydration to avoid confusion, increase alertness, improving memory, focus and attention.

v) Respiratory system. The mucus in the respiratory tract needs adequate hydration for thinning. If adequate hydration is not provided it will result in thickening of mucus and ultimately blocking the passage for gas exchange.Thus, hydration plays and important role in respiratory system.

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Ans. 3 Dehydration occurs when the fluid intake is inadequate or entirely lacking or when the fluid loss is abnormally increased through the natural/ unnatural routes. This occurs when the loss of water is not proportionate with the loss of electrolytes especially sodium or there is a gain in osmotically active substances. This results in an increased serum sodium level & osmolality (conc.) and intracellular dehydration.

In order to maintain health and normal functions of all the system of the body, fluid electrolyte and acid base balances within the human body are necessary. Not only necessary but their relative amounts must be maintained within a narrow range. The fluid and electrolyte balance in the body is called homeostasis.

These balances are maintained by the intake and output of water and electrolytes, their distribution in the body & the regulation of the renal and pulmonary function.Imbalance may result from various factors and are usually associated with illness.

A healthy individual can usually maintain normal fluid electrolyte and acid base balances because of the body's adaptive mechanisms. Illness, old gae , mobility, infancy,etc. may alter the adaptive mechanism and can cause imbalance.

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Ans. 4

-The intake and output monitoring

-Skin turgor assessment

-Inspection of lips (dry in poor hydration)

-Blood pressure monitoring.

-Assessment of peripheral veins

-Detailed history collection

-Presence of coomorbidities such as diabetes, renal impairment, heart diseases, etc.

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Ans. 5 a) In fever the rate of metabolism is very high than afebrile body. Thus the water loss occurs due to high temperature (body heat). The nausea and diarrhoea is also resulting in loss of water and electrolytes from the body. All this fluid and electrolytes loss results in dehydration.

c)We need to replace fluid and electrolytes immediately to meet the bodily needs.

IVF- isotonic (NS/ RL) fluid therapy will be started after calculation of total fluid requirements as per body weight.

Antipyretics for reducing body temperature to subside fever. Eg.IV Paracetamol

Antiemetic- to reduce nausea. Eg. IV Ondansetron.

Bed rest for dizziness management.

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