Saint Louis University

School of Nursing
s.y. 2014-2015
Dehydration:
GIT & Excessive
Glucose
Research Lecture
Clinical Group !
Su"#itte$ to% Sir &ennis Glen
'a#os
&ehy$ration% G()
*re$isposing
factors%
Age
Diet
Environment
*recipitating
factors%
Diarrhea
omiting
Predisposing factor: Precipitating factor:
Age Activities Increase Glucose in the Blood
Sex Genetic
Lifestyle Diet
Extracellular hyperglycemia
Loss of uid from plasma through osmosis Blood glucose reach renal threshold
Plasma !ecomes hyperosmotic Blood "ltered !y nephrons
Shift of uid from the interstitial uid to plasma Blood o#s to arteriole
Increase interstitial uid osmolality Glomerulus
$luid moves from intracellular to the extracellular uid $iltrate #as produces including
glucose
Decrease in E%$ and I%$ volume $iltrate passes through the proximal tu!ule
Increase in osmolality of E%$ and I%$
Glucose is rea!sor!ed from the "ltrate across the
tu!ular epithelium into the !loodstream
Dehydration of cell
Glucose level exceeds a!out &'()&*( mg+dl, proximal tu!ule
Begins to excrete glucose in the urine
Glucosuria
-smotic diuresis Glucose cause additional #ater to come into urine
Increase urine output
Dehydration
!igns and !ym"toms
-liguria
Elevated BP
Excessive thirst
Sun.en Eyes
/uscle Pain
$atigue
Diagnostic Test
B01 2Blood 0rea 1itrogen3
Serum creatinine concentration
%B% 2%omplete Blood %ount3
0rinalysis
#ursing Diagnosis
$luid volume de"cit
$luid and electrolyte im!alance
Impaired urinary elimination
Impaired tissue perfusion
4is. for impaired .in integrity
$edical $anagement
Isotonic Electrolyte solution for
hypotensive patients #ho have $5D6
1ormotensive, use hypotonic electrolyte solution6
Diagnostic uid challenge test 2&(()7(( mL of 1SS3
#ursing $anagement
/onitor and measure uid inta.e and output6
Daily #eight monitoring
S.in and tongue turgor6
-8er uids as tolerated6
+'eference%
Lippincott 9illiams : 9il.ins, Brunner : Suddarth;s <ext!oo. of
/edical)Surgical 1ursing &(
th
edition, 5olume & !y Su=anne %6
Smelt=er and Brenda G6 Bare, %hapter &>: $luid and Electrolytes
2Balance : Distri!ution3, pg6 7?@)7?A, 7(&(6
Sodium Needed for proper fluid balance, nerve
transmission, and muscle contraction
Table salt, soy sauce; large amounts
in processed foods; small amounts in
milk, breads, vegetables, and
unprocessed meats
Chloride Needed for proper fluid balance, stomach
acid
Table salt, soy sauce; large amounts
in processed foods; small amounts in
milk, meats, breads, and vegetables
Potassium Needed for proper fluid balance, nerve
transmission, and muscle contraction
Calcium Important for healthy bones and teeth; helps
muscles relax and contract; important in
nerve functioning, blood clotting, blood
pressure regulation, immune system health
Milk and milk products; canned fish
with bones (salmon, sardines); fortified
tofu and fortified soy milk; greens
(broccoli, mustard greens); legumes
Phosphorus Important for healthy bones and teeth;
found in every cell; part of the system that
maintains acidbase balance
Meat, fish, poultry, eggs, milk, processed
foods (including soda pop)
!agnesium "ound in bones; needed for making protein,
muscle contraction, nerve transmission,
immune system health
Bicar!onate is a maBor element in our !ody6 Secreted !y the
stomach, it is necessary for digestion6 9hen ingested, for
example, #ith mineral #ater, it helps !u8er lactic acid generated
during exercise and also reduces the acidity of dietary
components6 $inally, it has a prevention e8ect on dental cavities6