Concept of Dehydration – This book covers the entire syllabus of “Nutrition and Dietetics” prescribed by BNMC-for all Diploma in Nursing Science and Midwifery students. We tried to accommodate latest information and topics.
This book is examination friendly setup according to the teachers’ lectures and examination’s questions. At the end of the book previous university questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourished. The unique way of presentation may make your reading of the book a pleasurable experience.
Concept of Dehydration
Definition of Dehydration:
Dehydration is defined as excessive loss of body water.
or
In physiology, dehydration is a deficit of total body water with an accompanying disruption of metabolic processes.
Types of Dehydration:
1. No signs of dehydration.
2. Some dehydration.
3. Severe dehydration.
Assessment of Dehydration:
| Points | No signs of dehydration | Some dehydration. | Severe dehydration. |
| Look at condition | Well, alert | Restless, irritable | Lethargic or unconscious, floppy |
| Eyes | Normal | Sunken | Very sunken and dry |
| Tears | Present | Absent | Absent |
| Mouth and tongue | Moist | Dry | Very dry |
| Thirst | Drinks normally, not thirsty | Thirsty, drinks eagerly | Drinks poorly or unable to drink |
| Feel: Skin pinch | Goes back quickly | Goes back slowly | Goes back very slowly |
| Decide | The patient has no signs of dehydration. | If the patient has two or more sings including at least one sign, there is some dehydration. | If the patient has two or more signs including at least one sign, there is severe dehydration. |
Measures Should Be Taken In Various Degree Of Dehydration:
A. Measure should be taken for no sign of dehydration: Patient first seen with no signs of dehydration can be treated at home:
a) ORS packets should be given at home for 2 days,
b) Demonstration how to prepare and give solution,
c) After each loose stool the mother should give the following amount of ORS to her child.
| Age | Amount of ORS |
| Less than 2 years | 50-100ml |
| 2-9 years | 100-200ml |
| > 10 years | As much as wanted |
B. Home management:
a) Give more fluid than usual,
b) Give more food than usual.
c) Minimum one extra meal for two weeks,
d) Referral knowledge.
- If not improved within 3 days.
- More loose motion.
- Increased vomiting.
- Depressed anterior fontanels.
- Thirsty
- Unable to drink or food.
- Visible blood in stool.
- Fever.
Instruction to the mother of patient to return if any sign (above) develop.
C. Measure should be taken for some sign of dehydration: Rehydration therapy: ORS-75 ml/kg within 4 hours irrespective of age. Reassess after 4 hours. If improved then treated as no sign of dehydration if not, referred to the hospital.
D. Measure should be taken for severe dehydration : In severe dehydration, patient should be rehydrated by intravenous (IV) fluid such as cholera saline as follows:
| Age | 1st give 30 ml/kg | Then give 70 ml/kg |
| Infants (<I2 months) | 1 hour | 5 hours |
| Older (> 12 months) | 30 minutes | 2 14 hours |
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