Management of Fluid Volume Deficit
You wake up feeling horrible with a bad headache and feeling quite thirsty. Flashbacks from last night invade your mind, how hard you partied with your friends and how much drink you’ve had and how many trips to the restroom you’ve taken. You were YOLOing, as you prefer to call it.
You had great fun, actually, but you can’t really feel that now. Instead of reminiscing other happy memories from last night, here you are slowly getting out of bed, with cracked lips and is dying for a drink. You feel so dehydrated and weak. Will water be enough to quench your thirst? Do you need something else? Oh gosh, you just can’t think straight.
“I am never drinking anymore,” you say to yourself as you pour yourself a glass of cold water.
A closer look at dehydration
Dehydration, fluid volume deficit or hypovolemia is not only a case encountered in the hospital. In fact it can happen in day-to-day ordinary scenarios. Thus, everyone, healthcare provider or not, must be made aware on how to properly manage this as it happens.
Fluid volume deficit, occurs from a loss of body fluid or the shift of fluids into the third space, or from a reduced fluid intake. In other words, it occurs when you use or lose more fluid than you take in, and your body doesn’t have enough water and other fluids to carry out its normal functions.
Common sources for fluid loss are the gastrointestinal tract, polyuria, and increased perspiration. Fluid volume deficit may be an acute or chronic condition and may be managed in the hospital, outpatient center, or home setting. The goal here is to treat the underlying disorder and return the extracellular fluid compartment to normal. Usually, this is done by restoring fluid volume and correcting any electrolyte imbalances.
Early recognition and treatment is vital to prevent potentially life-threatening hypovolemic shock. Elderly patients are more likely to develop fluid imbalances.
You know you’re mildly-moderately dehydrated when you experience…
- Dry, sticky mouth
- Sleepiness or tiredness — children are likely to be less active than usual
- Decreased urine output
- No wet diapers for three hours (infants)
- Few or no tears when crying
- Dry skin
- Dizziness or lightheadedness
Treating dehydration in sick children
- Use an oral rehydration solution.These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes. They’re also designed for easier digestion.Begin giving fluids early in the course of an illness instead of waiting until the situation becomes urgent and be sure to give enough solution as it may be given in specific amounts, depending on the child’s age and degree of dehydration (as ordered by the doctor). Another thing to remember is to keep giving liquids slowly until the child’s urine becomes clear in color.
- Advise mother to continue breastfeeding.Offer the baby an oral rehydration solution in a bottle and continue to breastfeed. If baby formula is given, lactose-free formula must be given until diarrhea improves since lactose can be difficult to digest during diarrhea, making diarrhea worse.
- Avoid certain foods and drinks. The best liquid for a sick child is an oral rehydration solution since plain water doesn’t provide essential electrolytes, and although sports drinks replenish electrolytes, they mainly replace those lost through sweating, not through diarrhea or vomiting. Milk, caffeinated beverages, fruit juices or gelatins should be avoided temporarily as they don’t relieve dehydration and may make children’s diarrhea symptoms worse.
Treating dehydration in sick adults
For adults with mild to moderate dehydration usually from diarrhea, vomiting or fever, they may improve their condition by drinking more water or other liquids. Also, liquids such as fruit juices, carbonated beverages or coffee must also be avoided since they can make diarrhea worse.
You know you’re severely dehydrated when you experience…
- Extreme thirst
- Extreme fussiness or sleepiness in infants and children; irritability and confusion in adults
- Very dry mouth, skin and mucous membranes
- Little or no urination; any urine that is produced will be darker than normal
- Sunken eyes
- Shriveled and dry skin that lacks elasticity and doesn’t “bounce back” when pinched into a fold
- In infants, sunken fontanels
- Low blood pressure
- Rapid heartbeat
- Rapid breathing
- No tears when crying
- In the most serious cases, delirium or unconsciousness
Severe cases of dehydration warrant immediate medical attention. Those children and adults who are severely dehydrated should be treated by trained emergency personnel arriving in an ambulance or in a hospital emergency room, where they can receive salts and fluids intravenously rather than by mouth since it provides the body with water and essential nutrients much more quickly than oral solutions do, which is something that’s very important when it comes to life-threatening situations such as this.