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Ketones In Urine Dehydration

Department Of Emergency Medicine | Dehydration

Department Of Emergency Medicine | Dehydration

In young children, mild to moderate dehydration can happen very easily, particularly if the child has been in hot weather without drinking a sufficient amount of fluids, or if she has been experiencing diarrhea and/or vomiting. Timely and appropriate care is crucial in the assessment and management of dehydration in children because inadequate treatment can lead to serious, but preventable, complications. Although prevention is ideal, in some cases—like with excessive vomiting and diarrhea brought on by a bad “stomach flu”—dehydration is challenging to prevent. Making an accurate assessment that the child is dehydrated, or at serious risk of becoming dehydrated, is the single most important factor in making and carrying out the proper treatment decisions. Assessing dehydration If you suspect a child may be dehydrated, performing a thorough history and physical examination should be enough to confirm the diagnosis, help determine its cause and establish its severity. Factors like sunken eyes, crying without tears, lethargy, decreased frequency and/or volume of urination and fussiness are some of the signs of dehydration in children. Depending on the situation, a provider may perform the following tests to determine whether there is an underlying cause to the child's dehydration: blood count to determine the presence of a serious infection blood cultures to identify the type of bacterial infection blood chemistry to identify any electrolyte abnormality urinalysis to identify bladder infection, give evidence of severity of dehydration and/or identify sugar and ketones in urine (indicating inadequately treated diabetes) Managing dehydration in children Children who are dehydrated should begin treatment with oral re-hydration solutions (ORS), which help replace not j Continue reading >>

Ketones In Urine

Ketones In Urine

I know this is an old post, but people may still be checking for answers. I work in a laboratory where we do urinalysis constantly all day every day. In a pregnant woman, you can see ketones in the urine in two, but separate, circumstances. First is ketones in combination with any urine glucose (sugar) level. This may be a sign of gestational diabetes and you should start asking your doctor questions about it. Second is ketones by themselves. I'm 12 weeks pregnant and had ketones in my urine and was instructed by my doctor to go to the ER and get IV fluids. This was directly related to my eating habits, which at that point were near null because of the morning sickness. Because I was eating so little, and barely able to keep water down, my body was using my fat stores to supply nutrients to the baby. This breakdown of fat in such large amounts causes ketones as a waste product, which is then excreted through your urine. Ketones occur in the absence of carbs, when your body starts to use fat for calories. You will see ketones when you are eating very low calorie, very low carb, or have impaired insulin function. Ketones are concentrated in a state of dehydration. Excess glucose in urine indicates eating too many carbs (if you're diabetic) and/or impaired insulin function. Both are hallmarked by sweet smelling urine. Make sure you eat small meals during the day and add a night time snack, with a protein, to prevent ketosis while sleeping. If you think you have diabetes see a physician. I am 38 weeks pregnant and my urin showed high ketones this week. My blood sugar was in "acceptable" level; however, my doctor said that the presence of ketones in my urine means I need to drink alot more water because my body is converting carbs to sugar faster than I can exp Continue reading >>

Dehydration During Pregnancy

Dehydration During Pregnancy

What is dehydration? Dehydration is an insufficient amount of water in the body. Either insufficient drinking or excessive water loss from the body can lead to dehydration. Is dehydration in pregnancy a serious condition? Dehydration can be a mild nuisance or a life-threatening condition for both the mother and the baby. What are common causes of dehydration in pregnancy? A pregnant woman can become dehydrated from the same reasons as anyone other. Main causes include: Insufficient drinking Excessive sweating, mainly due to high ambient temperature Excessive urination Severe or prolonged diarrhea Severe or repeated vomiting Prolonged hyperventilation, for example due to anxiety and associated chronic hyperventilation syndrome. Morning Sickness Morning sickness can prevent a woman to eat and drink enough. In severe morning sickness called hyperemesis gravidarum, a woman can additionally lose a lot of fluid by repeated vomiting and is therefore at high risk for severe dehydration that requires admission to hospital and intravenous fluid replacement. Symptoms and Signs of Dehydration in Pregnancy MILD DEHYDRATION Symptoms: Thirst (not always), slight anxiety, slightly decreased frequency of urination Signs: Slightly increased heart rate. MODERATE DEHYDRATION Symptoms: Severe thirst (not always), dry mouth, decreased frequency of urination, dark yellow or tea-colored urine, tiredness, dizziness, headache, nausea, constipation. Signs: Increased heart rate, prolonged skin recoil after pinch and release (up to 2 seconds). SEVERE DEHYDRATION Nausea and vomiting, usually in the first trimester (but sometimes even in the third trimester), are the main causes of severe dehydration in pregnancy. Possible symptoms: Extreme thirst, but the woman may feel no thirst due to nausea Dry m Continue reading >>

Ketones In Urine During Pregnancy

Ketones In Urine During Pregnancy

Ketones in the urine during pregnancy is a health concern which some women experience during those crucial nine months. Although, it is not a high-risk pregnancy complication, studies reveal that it can be a cause of worry. Ketones are substances derived from fat breakdown. They are used by the body as a source of energy under emergency circumstances, like starvation or glucose deficiency, in order to survive. In other words, ketones in the urine are formed when the body's fat reserves are used to generate energy. Ketones in the blood further leads to ketosis. Weakness, nausea, lethargy, and excess sweating are signs of ketosis. Occurrence Our body gets its energy from the food we eat, which gets converted into glucose or blood sugar. It is insulin which provides an easy access to this blood sugar. During pregnancy, the placental hormones make the body resistant to insulin, which subsequently restricts the glucose in the blood from entering the cells. Hence, though the blood will be enriched with blood sugar, the cells will be deprived of the required energy. As a result, the cells start accessing other energy sources, like the fat stores, resulting in ketones as the byproduct of this entire process. Causes There can be various factors that may contribute to large ketones in the urine during pregnancy; dehydration and bad diet, to name a few. Others are enlisted below: ➤ Not getting enough calories from the food you are eating ➤ Long time intervals between meals ➤ Skipping meals or snacks ➤ Gestational diabetes ➤ Diets which include low intake of carbohydrates ➤ Dehydration - not drinking enough water ➤ Metabolic disorders ➤ Nausea, poor eating habits or throwing up ➤ Insulin resistance from hormones as a result of which the body is unable to access bl Continue reading >>

Dehydration In Children - Treatment

Dehydration In Children - Treatment

A A A Dehydration in Children (cont.) Be concerned if your child has an excessive loss of fluid by vomiting or diarrhea, or if the child refuses to eat or drink. Signs of dehydration include: Sunken eyes Decreased frequency of urination or dry diapers Sunken soft spot on the front of the head in babies (called the fontanel) No tears when the child cries Dry or sticky mucous membranes (the lining of the mouth or tongue) Lethargy (less than normal activity) Irritability (more crying, fussiness with inconsolability) Infants and small children can become dehydrated quickly. Contact your doctor if your child has any of the following: Crying without tears No urine output for over a period of four to six hours Sunken eyes Blood in the stool Vomiting for more than 24 hours, or vomiting that is consistently green in color Fever higher than 103 F (39.4 C) Less activity than usual Urination much more than usual If your child is lethargic (difficult to awaken) If you cannot reach your doctor If your child's mouth looks dry The doctor will perform a thorough history and physical exam in an effort to determine the severity and cause of the dehydration. Specific laboratory tests may be ordered. A complete blood count may identify an infection. Blood cultures may identify the specific kind of infection. Blood chemistries may identify electrolyte abnormalities caused by vomiting and diarrhea Urinalysis may identify bladder infection, may give evidence of the severity of dehydration, and may identify sugar and ketones in urine (evidence of uncontrolled diabetes). In some cases, the doctor may order other tests, such as a chest X-ray, a test to check for rotavirus, stool cultures, or lumbar puncture (a spinal tap). Continue Reading A A A Dehydration in Children (cont.) Dehydration in chil Continue reading >>

Diabetes And Dehydration: A Dangerous Combination

Diabetes And Dehydration: A Dangerous Combination

When you experience vomiting, nausea, fever, diarrhea, or any form of infection, you should immediately contact your physician. I can’t really emphasize enough the importance of getting treatment and getting it fast. To drive home this point, I’ll share the following experience. Some years ago, I got a call from a woman at about four o’clock on a Sunday afternoon. She wasn’t my patient, but her diabetologist was out of town for the weekend with no backup for emergencies. He had never taught her what I teach my patients — the contents of this chapter. She found my Diabetes Center in the white pages of the phone book. She was alone with her toddler son and had been vomiting continuously since 9:00 a.m. She asked me what she could do. I told her that she must be so dehydrated that her only choice was to get to a hospital emergency room as fast as possible for intravenous fluid replacement. While she dropped off her son with her mother, I called the hospital and told them to expect her. I got a call 5 hours later from an attending physician. He had admitted her to the hospital because the emergency room couldn’t help her. Why not? Her kidneys had failed from dehydration. Fortunately, the hospital had a dialysis center, so they put her on dialysis and gave her intravenous fluids. Had dialysis not been available, she would likely have died. As it turned out, she spent five days in the hospital. Clearly, a dehydrating illness is not something to take lightly, not a reason to assume your doctor is going to think you’re a hypochondriac if you call every time you have one of the problems discussed in this chapter. This is something that could kill you, and you need prompt treatment. Why is it, then, that diabetics have a more serious time with dehydrating illness th Continue reading >>

Dehydration In Children

Dehydration In Children

Dehydration means not enough fluid in a child's body. This can result from vomiting, diarrhoea, not drinking, or any combination of these three. Sweating or urinating too much can also cause dehydration, although this is far less common. Infants and small children are much more likely to become dehydrated than older children or adults. Causes of dehydration in children Dehydration is most often caused by a viral infection that causes fever, diarrhoea, vomiting and a decreased ability to drink or eat. Common viral infections causing vomiting and diarrhoea include rotavirus and winter vomiting disease (norovirus). Sometimes sores in a child's mouth caused by a virus make it painful to eat or drink, helping to cause or worsen dehydration. More serious bacterial infections can make a child less likely to eat and may cause vomiting and diarrhoea. Common bacterial infections include Salmonella, E coli, Campylobacter, and C.difficile. Parasitic infections such as Giardia lamblia cause the condition known as giardiasis. Increased sweating due to a very hot environment can cause dehydration. Excessive urination caused by unrecognised or poorly treated diabetes (not taking insulin) is another cause. Symptoms of dehydration in children You should be concerned if your child has an excessive loss of fluid from vomiting or diarrhoea, or if the child refuses to eat or drink. Signs of dehydration: Sunken eyes Decreased frequency of urination or dry nappies Sunken soft spot on the top of the head in babies (called the fontanelle) No tears when the child cries Dry or sticky mucous membranes (the lining of the mouth or tongue) Lethargy (less activity than normal) Irritability (more crying, fussiness) When to seek medical care: Seek urgent medical advice if your child has any of the follow Continue reading >>

Causes Of Protein In Urine During Pregnancy

Causes Of Protein In Urine During Pregnancy

Protein in Urine During Pregnancy Routine urine tests are part of prenatal visits to screen for infection or other conditions. Testing for the presence of protein in the urine (proteinuria) is necessary to determine if your kidney function is normal. Although proteins are normally absent in the urine, having a small amount of it during pregnancy is common. It can indicate kidney dysfunction, but it can also be related to infection, stress, or other conditions that need to be evaluated further. 1. Preeclampsia Women with this condition have high blood pressure during pregnancy, accompanied by water retention and protein in their urine. It can lead to complications, including babies with low birth weight. However, if diagnosed and treated early, affected women can deliver normal babies. Treatment includes consuming a healthy, low salt diet and engaging in regular exercise as recommended. Watch a video for more on Preeclampsia: 2. Kidney Infection or Urinary Tract Infection (UTI) UTI during pregnancy can cause protein to appear in the urine. If you feel the urge to urinate more frequently and suffer some discomfort during urination, you may have a UTI. If not treated promptly, this condition can cause kidney infection, which manifests as fever and chills, nausea, vomiting, and back pains. UTI may not adversely affect your baby, but a kidney infection can lead to premature labor and low birth weight babies. 3. Other Causes Factors that can cause transient increases in urinary protein include emotional stress, fever, exposure to extreme temperatures, dehydration, medications and strenuous exercise. Some medical conditions, however, can cause proteinuria that needs further investigation, such as heart disease, diabetes, leukemia, rheumatoid arthritis, lupus, sickle cell anemi Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

The Facts Diabetic ketoacidosis (DKA) is a condition that may occur in people who have diabetes, most often in those who have type 1 (insulin-dependent) diabetes. It involves the buildup of toxic substances called ketones that make the blood too acidic. High ketone levels can be readily managed, but if they aren't detected and treated in time, a person can eventually slip into a fatal coma. DKA can occur in people who are newly diagnosed with type 1 diabetes and have had ketones building up in their blood prior to the start of treatment. It can also occur in people already diagnosed with type 1 diabetes that have missed an insulin dose, have an infection, or have suffered a traumatic event or injury. Although much less common, DKA can occasionally occur in people with type 2 diabetes under extreme physiologic stress. Causes With type 1 diabetes, the pancreas is unable to make the hormone insulin, which the body's cells need in order to take in glucose from the blood. In the case of type 2 diabetes, the pancreas is unable to make sufficient amounts of insulin in order to take in glucose from the blood. Glucose, a simple sugar we get from the foods we eat, is necessary for making the energy our cells need to function. People with diabetes can't get glucose into their cells, so their bodies look for alternative energy sources. Meanwhile, glucose builds up in the bloodstream, and by the time DKA occurs, blood glucose levels are often greater than 22 mmol/L (400 mg/dL) while insulin levels are very low. Since glucose isn't available for cells to use, fat from fat cells is broken down for energy instead, releasing ketones. Ketones accumulate in the blood, causing it to become more acidic. As a result, many of the enzymes that control the body's metabolic processes aren't able Continue reading >>

Top 30 Doctor Insights On: Ketones In Urine Dehydration

Top 30 Doctor Insights On: Ketones In Urine Dehydration

1 It may: It is imperative to repeat the urine test once you have fully recovered from pancreatitis. It is also important to find out what precipitated pancreatitis and avoid those stimuli. For good health - Have a diet rich in fresh vegetables, fruits, whole grains, low fat milk and milk products, nuts, beans, legumes, lentils and ...Read more Continue reading >>

Urine Ketones - Meanings And False Positives

Urine Ketones - Meanings And False Positives

Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Urine Ketones article more useful, or one of our other health articles. Description Ketones are produced normally by the liver as part of fatty acid metabolism. In normal states these ketones will be completely metabolised so that very few, if any at all, will appear in the urine. If for any reason the body cannot get enough glucose for energy it will switch to using body fats, resulting in an increase in ketone production making them detectable in the blood and urine. How to test for ketones The urine test for ketones is performed using test strips available on prescription. Strips dedicated to ketone testing in the UK include[1]: GlucoRx KetoRx Sticks 2GK® Ketostix® Mission® Ketone Testing should be performed according to manufacturers' instructions. The sample should be fresh and uncontaminated. Usually the result will be expressed as negative or positive (graded 1 to 4)[2]. Ketonuria is different from ketonaemia (ie presence of ketones in the blood) and often ketonuria does not indicate clinically significant ketonaemia. Depending on the testing strips used, urine testing for ketones either has an excellent sensitivity with a low specificity, or a poor sensitivity with a good specificity. However, this should be viewed in the context of uncertainty of the biochemical level of significant ketosis[3]. Interpretation of results Normally only small amounts of ketones are excreted daily in the urine (3-15 mg). High or increased values may be found in: Poorly controlled diabetes. Starvation: Prolonged vomiting. Rapid weight loss. Frequent strenuous exercise. Poisoning (eg, with isop Continue reading >>

Ketosis: Why Women Need To Drink Their Way Through Labour

Ketosis: Why Women Need To Drink Their Way Through Labour

If you labour for a long time, you could be in danger of dehydration and developing complications such as ketosis. Here’s how to keep yourself safe and healthy during birth. There's so much going on during labour that the last thing that either you, or your birth partner, may think of is getting you to drink enough. Not that sort of drink obviously. There's no ordering a cheeky mojito with your epidural but you do need to keep your intake of water up when you're giving birth if you want to stay healthy, hydrated and keep any chance of developing a nasty case of ketosis at bay. What is ketosis? Ketosis is a complication of dehydration, and a lack of carbohydrates (or glucose) for energy in the body. It is the result of the abnormal accumulation of ketone bodies in the blood stream, body tissues and urine. When does ketosis occur? Ketosis happens when the muscles have little, or no, glucose for energy to be able to function efficiently. Once the glucose supply in the blood stream is depleted, the body starts to break down its fat stores for energy instead. This produces ketones, often causing a fever, body weakness and the muscles to function inefficiently, including the uterus. In cases where the ketosis is prolonged, the condition can develop into ketoacidosis. Ketoacidosis makes the person feel unwell and can damage their body organs. This is something that can occur for people who have uncontrolled diabetes. Ketosis and labour Ketosis is a common outcome for women who experience a prolonged labour (or pre-labour), becoming dehydrated and often causing their contractions to weaken, slow or stop. This can start to happen if glycogen (or glucose) is not being replenished through eating and drinking during labour. During labour, a woman has high-energy needs and her sto Continue reading >>

Ketonuria

Ketonuria

Ketonuria is a medical condition in which ketone bodies are present in the urine. It is seen in conditions in which the body produces excess ketones as an indication that it is using an alternative source of energy. It is seen during starvation or more commonly in type I diabetes mellitus. Production of ketone bodies is a normal response to a shortage of glucose, meant to provide an alternate source of fuel from fatty acids. Pathophysiology[edit] Ketones are metabolic end-products of fatty acid metabolism. In healthy individuals, ketones are formed in the liver and are completely metabolized so that only negligible amounts appear in the urine. However, when carbohydrates are unavailable or unable to be used as an energy source, fat becomes the predominant body fuel instead of carbohydrates and excessive amounts of ketones are formed as a metabolic byproduct. Higher levels of ketones in the urine indicate that the body is using fat as the major source of energy. Ketone bodies that commonly appear in the urine when fats are burned for energy are acetoacetate and beta-hydroxybutyric acid. Acetone is also produced and is expired by the lungs.[1] Normally, the urine should not contain a noticeable concentration of ketones to give a positive reading. As with tests for glucose, acetoacetate can be tested by a dipstick or by a lab. The results are reported as small, moderate, or large amounts of acetoacetate. A small amount of acetoacetate is a value under 20 mg/dl; a moderate amount is a value of 30–40 mg/dl, and a finding of 80 mg/dl or greater is reported as a large amount. One 2010 study admits that though ketonuria's relation to general metabolic health is ill-understood, there is a positive relationship between the presence of ketonuria after fasting and positive metabo Continue reading >>

Dehydration And Diabetes

Dehydration And Diabetes

Tweet People with diabetes have an increased risk of dehydration as high blood glucose levels lead to decreased hydration in the body. Diabetes insipidus, a form of diabetes that is not linked with high blood sugar levels, also carries a higher risk of dehydration. Symptoms of dehydration The symptoms of dehydration include: Thirst Headache Dry mouth and dry eyes Dizziness Tiredness Dark yellow coloured urine Symptoms of severe dehydration Low blood pressure Sunken eyes A weak pulse and/or rapid heartbeat Feeling confused Lethargy Causes and contributory factors of dehydration The following factors can contribute to dehydration. Having more of these factors present at one time can raise the risk of dehydration: Dehydration and blood glucose levels If our blood glucose levels are higher than they should be for prolonged periods of time, our kidneys will attempt to remove some of the excess glucose from the blood and excrete this as urine. Whilst the kidneys filter the blood in this way, water will also be removed from the blood and will need replenishing. This is why we tend to have increased thirst when our blood glucose levels run too high. If we drink water, we can help to rehydrate the blood. The other method the body uses is to draw on other available sources of water from within the body, such as saliva, tears and taking stored water from cells of the body. This is why we may experience a dry mouth and dry eyes when our blood glucose levels are high. If we do not have access to drink water, the body will find it difficult to pass glucose out of the blood via urine and can result in further dehydration as the body seeks to find water from our body's cells. Treating dehydration Dehydration can be treated by taking on board fluids. Water is ideal because it has no add Continue reading >>

Dangers Of Dehydration & Ketones In Pregnancy

Dangers Of Dehydration & Ketones In Pregnancy

I just spent the last weekend in the hospital getting a lesson from my doctor on the dangers of dehydration and ketones. It's common enough in pregnancy that I felt I would share with all of you. I was not even aware I was dehydrated, as I didn't feel any of the symptoms I will describe below. What is dehydration? Simply put, it's where your body eliminates more water than is being replaced. In your first trimester this is usually brought on my vomiting caused by "morning" sickness. Other culprits can be airplane travel and humidity. It is vitally important that you are drinking plenty of water throughout the entire day. A good rule of thumb is one glass for you; one glass for baby once per hour. Later in pregnancy, 2nd and 3rd trimester, dehydration can cause preterm labor. Actually, dehydration is the third most common reason that women experience preterm labor. When your doctor has you pee in a cup, they are checking for many things, one of them being dehydration and the other being ketones. Dehydration Symptoms: Signs and symptoms of dehydration include: Thirst. This is the first sign, and probably the most ignored. Listen to your body – if you’re thirsty, your body is trying to tell you something. You should try to maintain a schedule of drinking at least one glass of water an hour (more if needed). Dizziness. Dehydration may lead to feelings of dizziness, lightheadedness or vertigo, especially when standing up, bending over, or kneeling. This dizziness symptom is due to low blood pressure caused by dehydration. Headaches. Dehydration is a major cause of headaches, particularly migraines, in pregnant moms and non-pregnant folks alike. Don’t dismiss your headaches as hormonal (although, those can be a contributor). Make sure you’re drinking at least 10 pints Continue reading >>

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