What are the characteristics of hypotonic dehydration, and what are the main effects of hypotonic de

Clinical Core Test PointsChapter 7Pathophysiology Section 2 Water Savings, Sodium Metabolism Disorders04 Concept, Causes and Effects of Hypotonic Dehydration.

The differences between hyperosmolar, hypotonic and isotonic dehydration are: different serum sodium, different extracellular fluid osmotic states, and different manifestations. Hypertonic, hypotonic, and isotonic debalanced sensitive water are all internal water and sodium loss in the body.

First, serum sodium is different.

1. Hyperosmolar dehydration: hypertonic dehydration and sodium are lost at the same time, but the lack of water is more than the lack of sodium, and the serum sodium is higher than the normal range.

2. Hypotonic dehydration: Hypotonic dehydration and sodium are missing at the same time, but the water deficiency is less than the sodium deficiency, and the serum sodium is lower than the normal range.

3. Isotonic dehydration: isotonic dehydration water and sodium are missing at the same time, and water and sodium are lost in proportion, and serum sodium is in the normal range.

Second, the state of extracellular fluid osmosis is different.

1. Hyperosmolar dehydration: hyperosmolar dehydration of extracellular fluid is in a hypertonic state, the osmotic pressure of extracellular fluid increases, the secretion of antidiuretic hormone increases, the reabsorption of water by renal tubules increases, and the urine output decreases.

2. Hypotonic dehydration: Hypotonic dehydration of extracellular fluid is in a hypotonic state, and the body reduces the secretion of antidiuretic hormone, so that the reabsorption of water in the renal tubule is reduced, and the urine output is increased.

3. Isotonic dehydration: The osmotic pressure of the extracellular fluid of isotonic dehydration remains normal, resulting in a rapid decrease in the volume of extracellular fluid (including circulating blood volume).

Third, the performance is different.

1. Hyperosmolar dehydration: Hyperosmolar dehydration is manifested as extreme thirst, accompanied by fatigue, less urine, high urine specific gravity, and dry lips.

2. Hypotonic dehydration: Hypotonic dehydration is manifested as nausea, vomiting, rapid pulse, unstable blood pressure, blurred vision, and low urine output.

3. Isotonic dehydration: Isotonic dehydration is manifested as no thirst, less urine, anorexia, nausea, fatigue, dry tongue, dryness, relaxation, etc.

Encyclopedia – Hyperosmolar dehydration.

Encyclopedia - Hypotonic dehydration.

Encyclopedia – Isotonic dehydration.

The basic changes in the body during hypotonic dehydration are a marked decrease in extracellular fluid volume and a decrease in osmolality. Due to the decrease in the osmotic pressure of the extracellular fluid and the relatively high osmotic pressure of the intracellular fluid, the water is transferred from the outside of the cell to the intracellular, which makes the extracellular fluid more reduced and the intracellular fluid increases, so there is a tendency to develop cell edema. The effects of hypotonic dehydration on the body are mainly manifested as follows:

Prone to circulatory disorders and even shock, hypotonic dehydration under the action of the primary**, a large amount of body fluid is lost, and body fluids are transferred to the cell, which further reduces the extracellular fluid. Extracellular fluid hypotonic inhibits hypothalamic secretion, resulting in an increase or no decrease in urine output. As a result, blood volume is markedly reduced, which can easily cause circulatory dysfunction, such as venous collapse in shock, decreased blood pressure, tachypulse, abnormal mental status, and decreased urine output", and even kidney failure, azotemia, etc.

In hypotonic dehydration, the most obvious part of fluid loss is intercellular fluid, so patients have early signs of dehydration, such as decreased elasticity and sunken eye sockets. When hypotonic dehydration occurs in infants and young children due to toxic dyspepsia, there may be signs of dehydration, such as fontanelle depression, eye socket depression, and ** mucosal dry wrinkles, decreased elasticity, etc.

In the early stage of hypotonic dehydration, there is no significant decrease in urine output due to the decrease in osmotic pressure of extracellular fluid, and when the extracellular fluid is significantly reduced, the activity of renin, angiotensin, and aldosterone systems is enhanced, and the reabsorption of water and sodium by the renal tubules increases, and significant oliguria may occur. At the same time, the activity of the renin, angiotensin, and aldosterone systems is enhanced, resulting in increased tubular sodium reabsorption, so that in the later stages of hypotonic dehydration, patients not only have decreased urination, but also decreased urine sodium content and urine specific gravity. In the early stage of hypotonic dehydration, there is no thirst due to the hypotonic extracellular fluid, and patients in the middle and late stages will also have thirst.

Severe hypotonic dehydration has central nervous system symptoms such as apathy, drowsiness, and coma, which are related to central dysfunction caused by cerebral cell edema.

In the later stage, urine sodium should be divided into renal factors and extrarenal factors, and renal factors should be high in urine sodium.

Answer] :d hypotonic dehydration is due to low blood sodium, early fatigue, dizziness, and numbness of the means. In severe cases, it is a severe burn-out ring failure, with less urine and a lower specific gravity. Thirst is a sign of hyperosmolar dehydration.

Hypotonic dehydration: Electrolyte loss is greater than water, plasma osmolality is lower than normal, and serum sodium < 130 mmol. The symptoms of dehydration are more severe than those of other key oak types, and they are prone to shock, and neurological symptoms such as headache, drowsiness, cramps, and coma may occur.

It is more common in: Shengfan malnutrition with chronic diarrhea, extensive burns, chronic kidney disease and heart failure, long-term salt abstinence and repeated diuretics, diarrhea supplemented with large amounts of non-electrolyte solutions.

Answer]: C hypotonic dehydration, plasma osmotic pressure is low, sodium ion concentration is low, body fluid (first of all, extracellular fluid) is hypotonic, relatively speaking, intracellular sodium ion concentration is higher, resulting in water transfer balance to the cell, the difference mu of extracellular fluid is significantly reduced, the effective circulating blood volume is significantly reduced, and peripheral circulatory failure is prone to occur.