M8 - Dehydration

Question 1

Common causes of dehydration include lack of ____, ____, ____ etc or increased loss of ____ through ____, _____, _____, and profuse _____. ____ crisis and ____ stress, particularly in the ____ should be considered.

Answer 1

Mobility, confusion, coma
Fluids, vomiting, diarrhoea, diuresis, sweating
Diabetic, heat, elderly

Question 2

Symptoms of MILD clinical dehydration

Answer 2

• Decreased urine output
• Thirst
• Dry mucous membranes
• Mild tachycardia

Question 3

Symptoms of MODERATE clinical dehydration

Answer 3

• Mild symptoms (decreased urine output, thirst, dry mucous membranes, mild tachycardia) PLUS
• Decreased skin turgor
• Abnormal respiratory pattern
• Lethargy
• Sunken eyes/fontanelles

Question 4

Symptoms of SEVERE clinical dehydration

Answer 4

• Mild symptoms (decreased urine output, thirst, dry mucous membranes, mild tachycardia)/Moderate symptoms (decreased skin turgor, abnormal respiratory pattern, lethargy, sunken eyes/fontanelles) PLUS
• Poor perfusion: mottled, cool limbs, slow CRT, altered LOC
• Shock: threads peripheral pulses
• Marked tachycardia

Question 5

Management of dehydration (mild, moderate, severe), including medication (age, does, repeats, max)

Answer 5

1. Patient care (A2)
2. Assess severity of dehydration
   
   • Mild: Give oral fluids if tolerated
   • Moderate/Severe: Give oral fluids if tolerated;
     Compound Sodium Lactate (211): all ages: 10mL/kg IV/IO bolus, no repeats, max 1 dose
3. Treat associated conditions if indicated
4. Determine referral options
5. Regularly repeat and document ABCD physical examinations and physiological observations in order to identify trends in clinical deterioration.