Dehydration – Patient Care (Nursing)

by Rhonda Lawes, PhD, RN

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    00:00 Hi! Welcome to our video series on interpreting lab values.

    00:04 We're going to take a look at what happens to urine specific gravity when your patient is dehydrated.

    00:10 Now urine specific gravity is a ratio of the density of a substance compared to a standard when we talk about urine specific gravity, we're comparing urine to pure water.

    00:22 Normals range for urine specific gravity is 1.010 to 1.030.

    00:28 Now, this is the fun part.

    00:30 Let's apply it to your patient.

    00:31 Let's say we know they're dehydrated.

    00:33 So of course, I had to give them a fun name.

    00:36 Dee Hydrashun, - I know, I'm hysterical.

    00:39 Yeah, my students don't think so either.

    00:41 But at least they'll laugh at it.

    00:43 So dehydration has had intractable, that means extreme and unrelenting nausea, vomiting, and diarrhea for the past three days.

    00:52 Yeah, that's going to qualify for dehydration, right? Because anytime something leaves my body before it's supposed to, I end up losing a lot of fluid with it.

    01:03 That's why a patient who has vomiting, you're vomiting up gastric contents that have a lot more volume in it of water than they're supposed to.

    01:11 If they have diarrhea, it's all whipping through those intestines so quickly, the gut doesn't get time to reabsorb that water.

    01:18 So that's why a patient who's got extreme vomiting and diarrhea is generally dehydrated.

    01:25 Since a friend Dee Hydrashun, I know, I think that's funnier than you do.

    01:30 But they've had this extreme nausea, vomiting, and diarrhea for the past three days.

    01:35 She is dry, dry, dry.

    01:38 So what would you expect to happen to Ms. Hydrashun's volume status due to her extended emesis, - that's another word for vomiting and diarrhea.

    01:51 Right, we would expect her to be dehydrated.

    01:54 Now, before I move forward, I want you to answer a question what would her blood pressure be? What would the change to her blood pressure be? Would it be higher than normal? Would it be normal? Or do you expect it to be lower than normal? Cool.

    02:10 Today she's dehydrated.

    02:12 She's got a lot less of volume in her intravascular space, so her blood pressure should be decreased.

    02:19 Now in order for the body to compensate, will it slow down her heart rate with wrap up heart rate? or will there be no change? Initially, with less volume, when your blood pressure drops, your body will tell your heart to kick it in faster, faster, faster, faster, to move what you have around more quickly.

    02:38 So a classic sign of dehydration is lower blood pressure, higher heart rate.

    02:47 Now, let's look at another lab value.

    02:50 What would you expect this illness to have the impact on Ms. Hydrashun's urine specific gravity? Think about what you know.

    02:58 First of all, what is the normal urine specific gravity? Now, I know that she's dehydrated.

    03:04 So think about what her urine would normally look like.

    03:08 What do you predict would be the impact on her urine specific gravity? Write yourself a note before we go on, just to see where you are in understanding this concept.

    About the Lecture

    The lecture Dehydration – Patient Care (Nursing) by Rhonda Lawes, PhD, RN is from the course Urine Specific Gravity – Urinalysis (Nursing).

    Included Quiz Questions

    1. Blood pressure of 90/60 and a heart rate of 124 bpm
    2. Blood pressure of 122/84 and a heart rate of 110 bpm
    3. Blood pressure of 188/97 and a heart rate of 82 bpm
    4. Blood pressure of 94/65 and a heart rate of 62 bpm

    Author of lecture Dehydration – Patient Care (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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