Dehydration (A&E)

Question 1

Define dehydration.

Answer 1

State of reduced total body water volume

Question 2

What are some causes of dehydration? (7)

Answer 2

• insufficient water intake - particularly in elderly and critically ill
• diuretics
• diabetes insipidus
• diarrhoea
• vomiting
• burns
• sweating

Question 3

What are the clinical features of dehydration? (6)

Answer 3

• thirst
• headache
• weakness
• dizziness
• fatigue
• dry cool skin + dry mucus membranes + delayed CRT + reduced skin turgor

Question 4

What are the clinical features of dehydration in infants? (3)

Answer 4

• sunken fontanelle
• irritability
• lethargy

Question 5

What would you see on examination of dehydration? (5 + 3)

Answer 5

• dry mucus membranes
• loss of skin turgor
• increased capillary refill time
• sunken eyes
• severe dehydration: tachycardia, hypotension, delirium

Question 6

What electrolyte abnormality is found in dehydration?

Answer 6

Hypernatraemia

Question 7

What would happen to urine osmolality in dehydration?

Answer 7

Increased urine osmolality
(+ low urine sodium)

Question 8

What is urea:creatinine ratio like in dehydration?

Answer 8

Elevated urea:creatinine

Question 9

What is the management plan for dehydration?

Answer 9

• oral rehydration therapy
• IV fluid resuscitation

Question 10

What do we have to be careful about with IV fluid resuscitation in dehydration?

Answer 10

Correction of hypernatraemia too quickly can lead to cerebral oedema

Question 11

What are some complications of dehydration? (3)

Answer 11

• hypovolaemic shock –> pre-renal AKI
• thrombosis
• increased risk of UTIs