Dehydration: Signs, Symptoms and How to Avoid it

The body loses water all the time. A person responds to the thirst reflex by drinking fluids and eating foods that contain water. However if water is not adequately replaced, the body’s cells can lose water, a condition called dehydration.
How it happens

Loss of body fluids causes an increase in blood solute concentration (increased osmolality), and serum sodium level rise. In an attempt to regain fluid balance between intracellular fluid and extracellular spaces, water molecule shift out of cells into more concentrated blood. This process, combines with increase water intake and increased water retention in the kidneys, usually restores the body’s fluid volume.

Who is at risk?

Failure to respond adequately to the thirst stimulus increases the risk for dehydration. Confused, comatose, and bedridden patients are particularly vulnerable, as are infants, who cannot drink fluid on their own and who have immature kidneys that cannot concentrate urine efficiently. Older patients are also prone to dehydration because they have lower body-water content, diminished kidney function, and a reduced ability to sense thirst, so they cannot correct fluid-volume deficits as easily as younger adults. A patient may also become dehydrated if he or she is receiving highly concentrated tube feeding without enough supplemental water.

What to look for?

As dehydration progresses, watch for changes in mental status. The patient may complain of dizziness, weakness or extreme thirst. He may have a fever (because less fluid is available for perspiration, which lowers body temperature), dry skin, or dry mucous membranes. Skin turgor may be poor. It is because an older patient’s skin may lack elasticity, checking skin turgor may be an unreliable indicator for dehydration.

The patient’s heart rate may go up, and his or her blood pressure may fall. In severe cases, seizures and coma may result. Also, urine output may fall because less fluid is circulating in the body. The patient’s urine will be more concentrated unless he or she has diabetes insipidus, in which case the urine will probably be pale and produced in large volume.

How it is treated?

Treatment for dehydration aims to replace missing fluids. Because a dehydrated patient’s blood is concentrated, avoid hypertonic solutions. If the patient can handle oral fluids, encourage them. However, because the serum sodium level is elevated, make sure the fluids given are salt-free.

A severely dehydrated patient should receive Intravenous Fluids to replace lost fluids. Most patients receive hypotonic, low-sodium fluids such as dextrose 5% in water (D5W). Remember, if you give hypotonic solution too quickly, the fluid moves from the veins into the cells, causing them to become edematous. Swelling of cells in the brain can create cerebral edema. To avoid such potentially devastating problems, give fluids gradually, over a period about 48 hours.

How you intervene?

Monitor at-risk person closely to detect impending dehydration. If a patient becomes dehydrated, here are some steps you will want to take:
1.     Monitor symptoms and vital signs closely so you can intervene quickly.
2.     Accurately record the intake and output, including urine and stool
3.     Provide a safe environment for any patient who is confused, dizzy, or at risk for a seizure, and teach his family to do the same.
4.     Obtain daily weights (same scale, same time of day) to evaluate treatment progress.
5.     Provide skin and mouth care to maintain the integrity of the skin surface and oral mucous membranes.

Teaching Points

When teaching a person with dehydration, be sure to cover the following topics and then evaluate your patient’s learning:
1.     Explanation of dehydration and its treatment
2.     Warning signs and symptoms
3.     Prescribed medications
4.     Importance of complying with therapy.

Living with Paranoia

Kraeplin first coined the term “paranoia” and described it as systematized delusions lacking of global deterioration. People with pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent are more likely to develop this disorder, and it is the basis for criteria used to identify personality type. The following points are related to paranoia:

a.      Suspects, without sufficient basis, that others are exploiting, harming, or deceiving them;

b.     Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends and associates;

c.      Is reluctant to confide with others because of unwanted fear that the information will be used maliciously against them;

d.     Reads hidden demeaning or threatening meanings into benign remarks or events;

e.      Persistently bears grudge that is, is unforgiving of insults, injuries, or slights;

f.      Perceives attacks on his character or reputation that are not apparent to others and is quick to react angrily or to counterattack; and

g.     Have recurrent suspicions, without justifications, regarding fidelity of spouse or sexual partner.

4 SIGNS YOU ARE TOO PARANOID

YOU HOARD INFORMATION

“Paranoid people believe that keeping information to themselves given them an advantage,” says Marie McIntyre, PhD. Author of Secrets to Winning at Office Politics. “This backfires when coworkers stop sharing their good ideas.”

Get over it: Think strategically, says McIntire. Who is the best qualified to help solve your problem? Who can help you exploit what you know, the mutual advantage?

YOU MISTRUST SUBORDINATES

“If you are involved with every detail because you are afraid your direct reports or co-workers will mess it up, you have a problem,” says Michael Leiter, PhD, author of Banishing Burnout.

Get over it: Entrust your people with something you don’t care about, then build from there, Leiter suggests. Your newly empowered employees are likely to do a better job than you would have.

YOUR “CC” LINE IS NEVER EMPTY

“Paranoid employees want to make sure everyone knows when they have a good idea,” says McIntyre. “So they copy the whole company on e-mails.”

Get over it: Mass e-mails generate mass annoyance, especially when they are designed to stroke one’s own ego. “E-mail only the appropriate people,” says McIntyre. “And focus on how your accomplishment helps them.”

YOU LUNCH ALONE

Isolation is not a good means of protection, says Leiter, because the higher you rise, the more big shots have to sign off on your next move. Who you don’t know will hold you back.

Get over it: “Work creates a one-dimensional perception of others,” says Leiter. “If you get to know your colleagues outside the cube farm, you will realize they are not all plotting against you.

Situations that can Cause Depression in Children

We always believe that a child is less likely to suffer from depression. Maybe because we think that there are few stresses and tensions that are being faced by them compare to those which are encountered by adult. It is a misconception, since these tensions either minimal or not can still affect them which can cause depression in children. This article discusses about the different situations faced by the children that predisposes them to suffer from depression.

Situations that can initiate anxiety to children are preventable. It depends upon the current state of the environment where a child is living. Emotional support must be reinforced to children because it serves as the starting point in terms of molding them as a person. However, if these things are being disturbed, it can lead to depression in children. If a child suffers from physical abuse, it will remain in their consciousness as they grow. It is very hard for them to accept that they have been abused physically. A child has a right to a safe life which means that security must be observed within the premises of the family. If a child was abused by his or her parents, it can give them an idea to do the same thing in the future. If they have poor coping mechanism, they may suffer from depression.

They have fear in reporting their situation to the authority probably because they are overwhelmed with the situation and the abuser must have overpowered the child. If the child was sexually molested and abused by an adult, this can create serious problems. They may feel being used and perceive their body as worthless and filthy. It can lead to a condition where they suffer from continuous nightmares every time they sleep. This condition refers to Post Traumatic Stress Disorder (PTSD). If this condition is not properly managed, this can lead to depression in children.

A child who is emotionally abused will also suffer from depression. Emotional support is very crucial at that stage, since it serves as a molding point where their behavior should be carefully cultivated in a way that they can manifest appropriate attitude to other people. If a child who is severely abused emotionally will have the tendency to follow and practice what they have encountered. Most of the children who suffer from this condition are likely to develop personality which is too risky and later can develop into harmful behavior that can affect everyone who surrounds him or her.

A child who suffered from financial abuse is most likely to enhance their vulnerability to have depression in children. Children have the right to have sufficient support for their physiologic needs. This includes foods, shelter, cloth and other necessary materials for their growth and development. If the parents of the child can no longer support them, there is a great chance that a child can suffer from depression. The reason behind this situation, is that they feel being deprived from the things that they need in order for them to live normally.

A child who is bullied in the school can also suffer from anxiety that can lead to depression in children. Bullying is a part of the student’s life in school. But too much of it can create inferiority complex wherein they might feel worthless. Parents of a child who suffered from bullying must maintain proper communication wherein they can help the child to ventilate their feelings towards the scenario that affected them. Teachers must carefully observe the behavior of their students and these must be referred and coordinated to the parents. The purpose for these is to monitor the performance and standing of a child which are greatly affected due to intense bullying. Other option is to make an arrangement with the school personnel and transfer their kid to different school. It is best for the parents to reinforce the self-esteem of their child. Since, this can give an impact to their life at the later stage.

These are the common situations that can cause depression in children. Therefore, it is proven that kids’ even younger ones are prone to suffer from this kind of mental illness. Even they suffer from minimal stress, but sometimes it can surpass their coping mechanism and eventually can cause serious problems.