Dehydration vs Rehydration

01.04.2024 to 05.04.2024

Trigger 01:

Mr. Kumar, 34-Year-Old driver who works in CTB. He frequently takes meals from outside.
He was brought to the Accident and Emergency unit (A&E) with a history of fever, vomiting
and diarrhoea for two days duration. Next of kin revealed further in the history in the last day
he passed nearly ten times stools, refused to take adequate drinks or meals and he passed a little
dark coloured urine overnight. In A&E his vital parameters were recorded in supine position.

Respiratory rate was 30 breaths per minutes.

Lungs were clear on auscultation.
Pulse rate was 130 beats per minutes and low volume.
Extremities were cold.
Blood pressure was 100/50.
He was drowsy but arousable.
Capillary blood sugar level was 120mg/dL.
He weighed 60 Kg.

Trigger 1:

a) Define dehydration.
b) Explain briefly why he presented with above symptoms.

Trigger 2:

He was given with crystalloid intravenous solution following taken sample of blood for venous
blood gas analysis and the laboratory workup.

He was given intravenous medication (antiemetics) to cease further vomiting episodes.

a) Explain the term rehydration or fluid replacement.

b) List possible routes of rehydration in clinical setup.
 c) Identify the constituents of commonly used intravenous (IV) fluid preparations used in
fluid replacement.
d) Discuss the advantages and limitations of different IV fluids used in fluid replacement.

Trigger 3:

Venous blood gas analysis (VBG) report was available. It showed metabolic acidosis with
increased lactate level.

e) Explain the physiological basis of result of the VBG.

f) Will you really concern about VBG report? If so, explain how it can affect the body.

Trigger 4:

He became alert, his pulse rate became 92 bpm with good pulse volume after 1 L of intravenous
fluid therapy. He was orally tolerable to oral fluids. Oral rehydration solution (ORS) was started
as per his body weight.

g) Identify the constituents of different ORS formulae.

h) Discuss the advantages and limitations of ORS in treating dehydration.
i) Discuss the advantages and limitations of homemade oral fluid preparations in treating
in dehydration.
Trigger 5:

Laboratory blood tests were arrived.

In full blood count (FBC) test his pack cell volume (PCV) was 50.
Normal PCV ranges 40 to 45.

j) List the haematological parameters that can be interpreted in the full blood count report.
k) Briefly explain the physiological basis of high PCV.
l) Explain how monitoring PCV can help in the management of dehydration.