This document discusses dehydration and fluid overload. It describes the causes and symptoms of dehydration ranging from mild to severe, including thirst, orthostatic hypotension, and oliguria. Laboratory findings of dehydration include an increased BUN:creatinine ratio and hematocrit. Treatment involves intravenous fluid administration and blood transfusion if needed. Fluid overload is also covered, noting causes such as cardiac or renal failure. Symptoms include weight gain, edema, hypertension, and confusion. Laboratory tests may show decreased hematocrit and albumin levels. Treatment focuses on water restriction, diuretic use, and sodium restriction.

1. Anu Priya

5.  Volume of liquid ingested
-thirst centre in the hypothalamus
 Volume of urine excreted
-ADH from the post pituitary

6. • Dec in circulating volume
 CAUSES
a)Gut-vomiting,diarrhoea,fistulae
b)Skin and lungs
c)bleeding,burns
d)diuretic therapy

7. Mild: 4% loss TBW or < 15% blood
volume
 Moderate: 6% TBW or 15-30% BV
 Severe: 8% TBW or 30-40% BV
 Shock: >8% TBW or > 40% BV
 Clinical features:
◦ Thirst, sleepy, coma
◦ Orthostatic hypotension, tachycardia, decreased
JVP
◦ Poor turgor, hypothermia, dry membranes
◦ Oliguria, ileus, weakness

8.  Lab:
◦ BUN:Cr ratio greater than 20
◦ Inc. hematocrit
◦ Increased urine spec. gravity and osmolality

9.  Treatment:
◦ IV fluids
◦ Blood transfusion

10.  Etiology: Cardiac failure, Renal
failure,Hepatic failure, iatrogenic
 Clinical features:
◦ Wt gain
◦ Distended neck veins, pedal/sacral edema
◦ Hypertension,tachycardia,increased JVP
◦ Confusion,restlessness,convulsions
◦ rales or wheezing
◦ Pulmonary edema on CXR

11.  Lab:
◦ Decreased Hct and albumin
◦ Na may be low, normal or increased but total
body Na is usually increased
 Treatment:
◦ Water restrict to 1500 cc/day
◦ +/- Diuretics
◦ Sodium restrict to 0.5 gm/day
◦ (Albumin followed by diuretics)