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What is dehydration.?
A condition that occurs when the loss of body fluids, mostly water, exceeds
the amount that is taken in.
Sweat
Diarrhea
Vomiting
Sweat
Diabetes
Burns
Shifting of Water
Intracellular and extracellular osmorality must be kept in equilibrium
Disturbances that alters solute or water balance Shifting of water between
fluid compartments
Classified based on ECF osmorality:
1) . Isosmotic: No change in ECF osmorality
2) . Hyposmotic: Decrease in ECF osmorality
3) . Hyperosmotic: Increase in ECF osmorality
Dehydration States
Extrarenal
Renal
Extrarenal Causes
1) . Inadequate fluid intake
2) . Loss through GI tract (vomiting, diarrhea)
3) . Skin loss (sweating, fever)
4) . Third space loss: Trapping of fluid in transcellular space (edema, ascites)
Renal Causes
1) Osmotic diuresis
2) . Diuretic therapy
3) . Addison disease
Osmotic Diuresis
Diuretic Therapy
Addison Disease
Clinical Manifestation
Weight loss
Compensatory mechanism
Weak pulse
Hyponatremic Dehydration
More salt is lost than water (loss of hypertonic fluid) ECF sodium falls (<
130 mEq/L)
Decrease ECF osmorality Water shifts from ECF to ICF
ICF volume increases Swelling of cells
Causes
Extrarenal
Renal
Extrarenal Causes
1) Loss through GI tract (vomiting, diarrhea)*
2) . Third space loss: Trapping of fluid in transcellular space (pancreatitis)*
* Replacement fluid are hypotonic compared to loss
Renal Causes
1) Osmotic diuresis
2) . Loop diuretics
3) . Addison disease
4) . Cerebral salt-wasting
Loop Diuretics
Neuromuscular tissue
Gastrointestinal manifests
Hypernatremic Dehydration
More water is lost than salt (Loss of hypotonic fluid) ECF sodium rises (>
150 mEq/L)
Fluid initially lost from plasma Increase plasma osmolarity
Water shifts from interstitial fluid to plasma Increase interstitial osmorality
Water shifts from ICF to ECF Both ECF & ICF volume decreases & shrinking
of cells
Causes
Extrarenal
Renal
Extrarenal Causes
1) . Inadequate fluid intake
2) . Excessive skin loss (sweating)
3) . Loss through respiration (fever, exercise)
4) . Increased loss through GI tract (diarrhea, vomiting)
Renal Causes
1) Osmotic diuretics
2) . Central diabetes insipidus
3) . Nephrogenic diabetes insipidus
Central Diabetes Insipidus
Inability of posterior pituitary to secrete ADH
Produce a large volume of dilute urine and body fluid becomes concentrated
Produce a large volume of dilute urine and body fluid becomes concentrated
Clinical Manifestation
Compensatory mechanism
Weak pulse
Headache
Decreased reflexes
Laboratory Diagnosis
Urinalysis. Tests done on your urine can help show whether you're
dehydrated and to what degree.