Module 4. Dehydration Due to Illness

Transcription

1 Module 4 Due to Illness

2 Introduction We naturally lose water every day through 1a : Breathing Sweat Urinating Bowel movement When there is not enough water in our bodies, or more water is leaving the body than what is being taken in, we become dehydrated 2a. Water is essential for the body to keep performing its everyday functions 1b, which is why it is so important to stay hydrated. To replace this natural loss of fluid, a person needs to take in an adequate amount of water each day 1c. When we lose water we also lose electrolytes, which are substances that need to be balanced for cells and organs to function normally 3. There are six major electrolytes present in the human body 4 : can be expedited by illness either through accelerated water loss or by a reduction in water intake 1e. Conditions That Could Lead to Diarrhoea: The most common reason for dehydration. Excess water is lost through bowel movements 1e. Vomiting: Fluid is lost in the vomitus, and replenishment is hampered by nausea and continued vomiting 1e. Sweat: Significant amounts of water can be lost because of a fever due to an infection, such as a cold or flu; the body uses water in the form of sweat to cool itself 1e. Diabetes: High blood sugar levels cause sugar to spill into the urine and water then follows, which may cause dehydration 1e. Burns: The damaged skin is compromised and cannot properly regulate fluid leaving the body 1e. A variety of serious illnesses: Various illnesses could lead to the inability or unwillingness to drink or eat, due to cold sores, nausea and a sore throat 5a,6.! Those at Risk of Infants and young children: Infants and young children with diarrhoea may lose a higher percentage of fluids than teenagers or adults might 2b. Na Mg P Cl - K Ca Older people: Older peoples thirst centres can become less sensitive, and they may not realise they re becoming dehydrated 2c. Sodium Magnesium Phosphorous Chloride Potassium Calcium We'll look at the important roles that each of these electrolytes performs in the Summer Study Pack. Fast Fact Up to 75% of the body's weight consists of water 1d

3 The Symptoms of Depending on how severe the fluid loss is and how long the process lasts, dehydration can be anywhere from mild or moderate to severe 2d, 2e. Mild to Moderate Diagnosis of Easily diagnose dehydration this way: Symptoms include: Adults Increased thirst 2d Less sweating 2d Reduced skin elasticity 2d Decreased urine production 2d 2d, 7a Dry or sticky mouth Severe Symptoms include: Adults Very dry mouth, skin and mucous membranes 7b Little or no urination any urine that is produced will be darker than normal 7b Decreased blood pressure hypotension may cause light-headedness or fainting upon standing 2e Confusion a good indication that dehydration has become severe, since brain cells are being affected 2e Faster than normal heart rate tachycardia 5b Increased or rapid breathing 5b Lethargy 5b Babies Sleepiness or tiredness 7a No wet diapers for three hours for infants 7a Few or no tears when crying 7a Headache 7a Constipation 7a 2d, 7a Dry or sticky mouth Babies Sunken eyes 5b Sunken fontanelles the soft spot at the top of the baby s head 5b Faster than normal heart rate tachycardia 5b Increased or rapid breathing 5b Lethargy 5b If dehydration worsens, the internal organs, such as the kidneys, brain and liver 2e, may go into severe shock. Extremely severe dehydration could lead to the patient falling into a coma 2e. 1. Do a pinch test Grab a roll of skin on the back of your hand. If the skin remains raised, you might be dehydrated 8a. 2. Check your urine A well-hydrated body produces mostly clear urine with a tinge of yellow. Darker yellow or orange urine are colours that warn that you might be dehydrated 8b. Note: Certain foods, such as beetroot, darken urine. Various vitamins and medications may also change the colour. 3. Test for bad breath Breathe into your cupped hands and inhale through your nose to check. Lack of saliva can lead to a bacteria overgrowth and bad breath 8c. 4. Notice a craving for sweets slows down the liver s production of glycogens, which leads to intense cravings for food, especially sweets 8d

4 Treatment of The common treatment for dehydration is replacing fluids through oral replacement therapy. In the case of severe dehydration it might, however, be necessary for a doctor to administer an intravenous (IV) solution to the patient. This same treatment is used for patients who are unable or unwilling to drink, such as children or those suffering from repeated vomiting 5c who are unable to keep fluids down. Case Study Naledi, 27, Actress Mild Drink more fluids 2f, such as water and herbal teas Moderate Replacement of fluid and electrolytes through rehydration solutions (ORS) 2f Severe Replacement of sodium and potassium in particular 2f Extreme Patients need to be treated with IV fluid 5c Naledi has come to the pharmacy to ask for advice. She tells you that she s feeling tired, and she has a headache. She has also been feeling very thirsty and has a dry mouth. She wonders whether it could be dehydration, but she s not sure, since it s winter. Note: Sometimes an underlying disorder or cause of the dehydration, such as diarrhoea, may also need to be treated 2g to ensure swift and complete recovery. Learn more about how Imodium can help treat the symptoms of diarrhoea in the Summer Study Pack. She would like to know which OTC product she can use that will help her feel better. Oral Rehydration Solutions (ORS) ORS are available from pharmacies without a prescription 2h. These solutions work effectively for all patients who are suffering from dehydration regardless of their age and the cause or type of electrolyte imbalance 9a. Kidney dysfunction is, however, a contra-indication, and ORS should be avoided in these cases 9a. In the case of moderate to severe dehydration, sports drinks, canned cold drinks and juices do not meet the same necessary oral rehydration criteria as ORS, since they often contain too little sodium and too many carbohydrates 9b. An effective ORS usually contains a balanced combination of the following substances 9c : Glucose with or without complex carbohydrates Sodium Potassium Chloride Citrate buffer Ask the following questions: How long have the symptoms lasted for? Has she been taking any medication? Has she been sick recently? Is she experiencing diarrhoea or constipation? Has she been doing a lot of exercise or has she physically exerted herself? How severe is her headache? Have you been drinking water? Naledi tells you that she has not exerted herself physically, but she has spent a lot of time outside recently in the cold weather because she was shooting a commercial, and she s not sure that she s been drinking enough water. She has been suffering from a light bout of diarrhea for the past two days, but is better now. Her headache is dull and constant, but not severe. Diagnosis: You establish that Naledi is dehydrated

5 Since we are less likely to realise we are thirsty in the winter, remind Naledi that despite the weather being cold she needs to keep consuming an adequate amount of fluids so she doesn t run the risk of becoming dehydrated. Treatment Since Naledi is suffering from dehydration you can recommend the following product: Rehidrat For the treatment of dehydration and electrolyte loss due to gastroenteritis and diarrhoea.! Urgent Assistance Patients need to seek immediate attention in the case of 10a : Increased or constant vomiting for more than a day Fever over 38,5 C Diarrhoea for more than 2 days Weight loss Decreased urine production Confusion Sluggishness (lethargy) Patients must visit a hospital or emergency room in case of 10b : Fever over 39,5 C Seizures Difficulty breathing Chest or abdominal pains Fainting No urine production in the last 12 hours Dosage Dissolve 1 sachet in 250 ml of freshly boiled and cooled water. Maintenance Therapy: < 1 year old: ml after every bowel movement. 1 5 years old: 200 ml after every bowel movement. Older children and adults should drink enough Rehidrat to quench their thirst and replace the fluid lost in every stool. Mild : 50 ml / kg body mass for first 6 hours, followed by maintenance therapy. Moderate to Severe : 100 ml / kg body mass for first 6 hours, followed by maintenance therapy. Please note: If a patient s dehydration is due to diarrhoea you can recommend Rehidrat in conjunction with Imodium, which will be discussed in the Summer Study Pack

6 REHIDRAT SA s #1 oral electrolyte solution 11. Helps to replenish lost fluids, thereby assisting with recovery. Optimal balance of sugars, salts and minerals. Test Your Knowledge You ve reached the end of the module. You can test your knowledge right away while the info is fresh, or you can complete the full Class Test in one go once you reach the end of this Study Pack. See the back page of the booklet for more details on how to complete and submit your test. Below are the questions from the Class Test that applies to the module you just finished. The full Class Test appears on the Fax Sheet included separately. No artificial preservatives, sweeteners or colourants. Suitable for children under 1 year of age. 3 palatable flavours: Blackcurrant, Orange and Vanilla. Available in convenient 6 pack and single sachets. 1 When it comes to dehydration, in which situation does the patient not have to go to the hospital immediately? a Fever over 39,5 C b Seizures c Difficulty breathing Why Rehidrat? Rehidrat is suited for the whole family and is scientifically formulated, to deliver the movement of electrolytes and carbohydrates into the blood stream, to speed up rehydration and quickly replenish and recover your energy. Rehidrat is a pure hydration powder, with no artificial flavourings or large amount of sugars and contains the right balance of sodium, potassium and glucose to get the body back to optimal health after dehydration. 2 Which d Increased thirst one of the following statements about REHIDRAT is false? a It offers an optimal balance of sugars, salts and minerals b No artificial preservatives, sweeteners or colourants are used c Not recommended to children under 2 years of age d It comes in 3 palatable flavours: Blackcurrant, Orange and Vanilla S0 REHIDRAT ORANGE. Reg. No. Y/24/181. S0 REHIDRAT BLACKCURRANT. Reg. No. Y/24/ What does ORS stand for? a Oral Rehydration Solution S0 REHIDRAT VANILLA. Reg. No. N/24/103. Each 14 g sachet of powder contains: Sodium Chloride 0,44 g, Potassium Chloride 0,38 g, Sodium Bicarbonate 0,42 g, Glucose 4,1 g, Sucrose. 8,1 g. b c d Oral Rehydration Substance Oral Replacement Sports Drink Oral Rehydration Solvent 82 83

7 References 1. MedicineNet.. Available at Accessed on 23 March Porter RS (Ed). : Water balance. The Merck Manual Home Health Handbook. Available at hormonal-and-metabolic-disorders/water-balance/dehydration. Accessed on 22 December MedicineNet. Electrolytes. Available at Accessed on 22 December MedlinePlus. Electrolytes. Available at Accessed on 22 December Porter RS (Ed). and Fluid Therapy in Children: in Children. The Merck Manual of Diagnosis and Therapy. Available at Accessed on 22 December MedlinePlus.. Available at Accessed on 22 December Mayo Clinic.. Available at Accessed on 22 December Everydayhealth. 6 Unusual Signs of. Available at Accessed on 3 April Porter RS (Ed). and Fluid Therapy in Children: Oral Rehydration. The Merck Manual of Diagnosis and Therapy. Available at Accessed on 22 December WebMD. in Adults. Available at Accessed on 22 December IMS October MAT