Dehydration

Question 1

Explain how HYPONATREMIC dehydration causes seizures

Answer 1

Greater loss of Na than water

• -> ECF goes to intracellular compartments
• -> increased ICF
• -> increased brain volume
• -> seizures

Question 2

Explain how HYPERNATREMIC dehydration causes seizures

Answer 2

Greater loss of water than NA

• -> ICF leaves intracellular compartments
• -> brain shrinks
• -> seizures

(also get hyperreflexia, reduced GCS, multiple small cerebral haemorrhages)

Question 3

6 red flags for shock in a currently dehydrated patient

Answer 3

1. Deteriorating child
2. Irritability, lethargy (altered responsiveness)
3. Sunken eyes, fontanelle depression
4. Tachycardia
5. Tachypnoea
6. Reduced skin turgor

Question 4

4 indications that a patient has gone into shock

Answer 4

1. Pale/ mottled skin
2. Cold extremities
3. CRP >2s
4. Hypotension