DEFINITION

Dehydration occurs when there is an inadequate amount of body fluid

to maintain normal body functions. Water in the body contains substances vital to
normal operation of the heart, brain, and kidneys. These substances, of which
potassium and sodium (salt) are the most important, are lost whenever there's a loss
of body fluid, such as through vomiting, diarrhea, even excessive sweating, burns,
and inability to drink.

SIGNS AND SYMPTOMS

Mild Dehydration
 Thirst. If you wait to drink something until you're thirsty, you're already a
little bit dehydrated. This means most of us experience very mild
dehydration on a regular basis.
 Dry oral mucous membrane.
 Dry lips.

Moderate Dehydration
 A very dry mouth.
 Eyes are sunken
 When you pinch your skin (such as the skin on the back of your hand), it
doesn't immediately return to its normal position. This lack of elasticity is a
good indicator of dehydration.
 In babies, the soft spots (fontanelles) on the infant's head may look sunken.

Severe Dehydration
 All of the above signs of moderate dehydration.
 Cold hands and feet.
 A weak, rapid pulse, even at rest.
 A rapid breathing rate.
 Confusion.
 Lethargy. The patient may be difficult to arouse.
 COMPLICATION if left UNTREATED

Kidney failure
Kidney failure is a common occurrence, although if it is due to
dehydration and is treated early, it is often reversible. As dehydration progresses,
the volume of fluid in the intravascular space decreases, and blood pressure may
fall. This can decrease blood flow to vital organs like the kidneys, and like any
organ with a decreased blood flow; it has the potential to fail to do its job.

Coma
Decreased blood supply to the brain may cause confusion and even
coma. If enough organs begin to malfunction, the body itself may fail, and death
can occur.

Shock
When the fluid loss overwhelms the body's ability to compensate, blood
flow and oxygen delivery to the body's vital organs become inadequate and cell
and organ function can begin to fail.

PREVENTION

 When you are exercising, make sure you're continually drinking fluid to
replace those lost through sweat. In times of extreme heat, you may want to
skip your workout, or exercise indoors in an air-conditioned environment to
avoid dehydration and heat illness.

 If you have children, be aware that dehydration can occur during any illness.
Be prepared: know the symptoms of dehydration, and it's not a bad idea to
have a bottle of children's electrolyte solution on hand to avoid an
emergency trip to the store with a sick child in tow! If you have any doubts
or questions about the development of dehydration in your ill child, call your
doctor.
  Drink at least 8 glasses of water daily.

FIRST AID

Prevention is the FIRST STEP.

For mild dehydration

 A sports drink, such as Gatorade, is best, but plain water will do.
 Do not give the patient any alcohol, or drinks containing caffeine. Alcohol
and caffeine are diuretics, meaning they'll just cause more fluid loss.
 Children who are mildly dehydrated can be given a pediatric electrolyte
solution, such as Pedialyte, Ceralyte, and Oralyte. This replaces fluids and
important minerals, without all the sugar found in sports drinks.
 In INFANT, continued BREASTFEEDING is important.
 Give home-made ORS: 1 teaspoon of salt, 8 teaspoon of sugar in Litre of
drinking water.
 Deliver about 50 mL of ORS per 1 kg of weight over a 4-hour interval

For moderate dehydration

 Especially in children, call your doctor for advice. Children can become
severely dehydrated very quickly, so let your doctor decide whether your
child's dehydration can be treated at home, or requires medical attention.
Intravenous fluids may be needed for moderate dehydration (child or adult).
 The rehydration goal at this level of dehydration is to deliver about 100
mL/kg of ORS over 4 hours.
 Individuals with vomiting and diarrhea can try to alter their diet and use
medications to control symptoms to minimize water loss. Clear fluids often
recommended as the diet of choice for the first 24 hours, with gradual
 progression to a BRAT diet (bananas, rice, apples, and toast) and then
adding more foods as tolerated.
 Loperamide (Imodium) may be considered to control diarrhea
 ibuprofen may be used to control fever

For severe dehydration

 It is necessary to GO at NEAR HOSPITAL especially in INFANT!

NURSING CARE

 Remove any excess clothing and loosen other clothing.

 Air-conditioned areas are best for helping return body temperatures to
normal and break the heat exposure cycle.
 If air conditioning is not available, increase cooling by evaporation by
placing the person near fans or in the shade, if outside. Place a wet towel
around the person.
 If available, use a spray bottle or misters to spray luke-warm water on
exposed skin surfaces to help with cooling by evaporation.
 Avoid exposing skin to excessive cold, such as ice packs or ice water.
 Proper health teaching to the patient and relatives help to avoid recurrence of
dehydration
 Monitor Intake and Output.
 Mental status tests to evaluate whether the patient is awake, alert, and
oriented.
 Vital signs 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 fluid.
 Pediatric patients are weighed