The Arizona STEM Acceleration Project

Anatomy of Dehydration

Anatomy of Dehydration

A 11/12 Grade STEM Lesson

Jess Bushman

February 2024

Notes for Teachers

• Teachers notes are in read, students slides match up with teacher notes.
• This is a 2-3 day discussion, lab and calculation lesson
• Articles attached (to the right) can be used as homework or pre-discussion knowledge or can be read and discussed in class to add time to the lesson
• each article has questions at the end
• This lesson can be used in connection with a cardiac unit

List of Materials

• Student Slide Show
• Electrolytes Lab Packet
• Different Electrolyte Drinks to test
• Water
• Salt
• Petri dish
• Uninsulated Copper wire - 2 pieces about 7 inches each
• 9V battery
• 9V battery snap connector Battery
• 4 inch piece of Straw
• 3 alligator clips (1 red, 2 black)
• Multimeter with red and black probes
• AND/OR
• Light bulb with mini bulb holder
• Article “Indiana Mom of 2 Dies After Drinking Too Much Water on Family Vacation”
• Article “Sports Drinks, Do They Really Work?
• Article “Dehydration”
• Blank Heart Diagram
• IV Calculation Scenarios
• IV Calculation Scenarios - Answers
• Assessment
• Assessment answers

Standards

• Essential HS.L1U1.20 Ask questions and/or make predictions based on observations and evidence to demonstrate how cellular organization, structure, and function allow organisms to maintain homeostasis.
• Plus HS+B.L1U1.6 Develop and use models to show how transport mechanisms function in cells.

• ​

HS-LS1-7 From Molecules to Organisms: Structures and Processes

• Use a model to illustrate that cellular respiration is a chemical process whereby the bonds of food molecules and oxygen molecules are broken and the bonds in new compounds are formed resulting in a net transfer of energy.
• S-LS1-7. Use a model to illustrate that cellular respiration is a chemical process whereby the bonds of food molecules
• and oxygen molecules are broken and the bonds in new compounds are formed, resulting in a net transfer of
• energy.
• is a chemical process whereby the bonds of food molecules
• and oxygen molecules are broken and the bonds in new compounds are formed, resulting in a net transfer of
• energy.
• HS-LHS-LS1-7. Use a model to illustrate that cellular respiration is a chemical process whereby the bonds of food molecules
• and oxygen molecules are broken and the bonds in new compounds are formed, resulting in a net transfer of
• energy.
• S1-7. Use a model to illustrate that cellular respiration is a chemical process whereby the bonds of food molecules
• and oxygen molecules are broken and the bonds in new compounds are formed, resulting in a net transfer of
• energy.
• ​

1.1.1a - Cellular level of organization

1.1.2d - Cardiovascular - cardiac conduction

1.3.1a-c - Medical Mathematics

AZ Math Standards

Standards for Mathematical Practice

​

P.MP.4 Model with mathematics

​

A2.A-SSE.B Write expressions in equivalent forms to solve problems. A2.A-SSE.B.3 Choose and produce an equivalent form of an expression to reveal and explain properties of the quantity represented by the expression.

Teacher Background Knowledge

• Measuring Electrolytes in Sports Drinks
• Health Benefits of Sole Water (article)
• Why is drinking water so important?
• Sports Drinks Science: Is it Hype?
• Heart Electrical Conduction System Animation ECG
• How to read and EKG (Made Easy)
• Fluids and Electrolytes for Nursing Students

Objective(s):

Understand how electrolytes help the conductivity of your heart, understand the importance and possible dangers with water consumption (on a cellular level), and to understand the calculation that doctors and nurses make to help dehydrated children.

Agenda

• Articles can be used as in class discussion for additional time or can be done as homework and pre-knowledge for class discussion
• Discussion about hydration / electrolytes / heart anatomy / basic heart rhythms
• 55 min
• Medical calculations
• 15-20 min
• Electrolyte Conduction Lab (depending on how many liquids you have)
• 20 min
• Assessment
• 25 min

Intro/Driving Question/Opening

​

​

How much water should we drink?

What sports drinks are the best?

How do Sports Drinks affect your heart?

How Does Hydration Help the Body?

• Brings nutrients and oxygen to cells
• Takes waste out of cells
• Protects joints
• Protects organs
• Maintains homeostasis - body temperature
• Aids in digestion
• Improves skin
• Helps your heart pump blood

​

• When cells are dehydrated, hypernatremia (high salt)
• causes water to be pulled out of the cells
• Overhydration, hyponatremia (low salt)
• causes extra water to be pushed into cells
• When cells are in a homeostatic state, there is a balance of fluid
• Fluid moves in and out of cells through osmosis
• water moves to balance out concentration of solute
• this movement can be against pressure gradient

Images obtained from: https://openoregon.pressbooks.pub/app/uploads/sites/98/2020/04/image2-1.png

What are Electrolytes?

• Electrolytes are minerals found in Sports Drinks that the body needs:
• Sodium
• Calcium
• Potassium
• Magnesium
• Phosphate
• Chloride

Image obtained from :https://sciencenotes.org/wp-content/uploads/2017/05/PeriodicTableWallpaper2017.png

Images obtained from: https://i5.walmartimages.com/seo/Gatorade-Thirst-Quencher-Orange-28oz-Bottle_08e92cf5-b27a-4c0f-a7f1-cc816546357c_1.871e04fcef49c26bc171ec1b51789309.jpeg

https://assets.wakefern.com/is/image/wakefern/5200020807-577?$Mi9Product_detail$

https://www.kroger.com/product/images/large/back/0004900003278

https://i5.walmartimages.com/asr/5f520769-467b-4833-975e-a21ee9d2a921.af4406b93a86a8fc2d432619fcbb8337.jpeg?odnHeight=768&odnWidth=768&odnBg=FFFFFF

• Sole (so-lay) water is water and Himalayan Pink salt - no added sugars or colors
• Pink Himalayan salt is 96-99% NaCl
• traces of calcium, iron, zinc, chromium, magnesium, and sulfate

Image obtained from: https://thecoconutmama.com/wp-content/uploads/2023/03/Salt-Water-Sole-jpg.webp

Can you drink too much water?

• YES!!!
• Water intoxication or water toxicity is where sodium levels in the body are depleted.
• Hyponatremia is when the body is low on sodium
• Low sodium can cause confusion and headaches and low heart rates
• People that have water intoxication also run the risk of developing new onset Atrial fibrillation (A-fib)
• New onset A-fib can lead to blood clots that can then cause strokes

Heart Anatomy

Heart

Electrical Conductivity of the Heart

• Cardiac muscle produces and then conducts its own electrical impulse
• Impulse starts at the Sinoatrial Node (SA node) in the Right Atrium
• Then goes to the Atrioventricular node (AV node) the junction of the 4 chambers
• Goes through the Bundle of His in the septum
• Through the Left and Right Bundle Branches in the septum toward the apex of the heart
• Then the Purkinje fibers around the ventricles

Images obtained from:https://my.clevelandclinic.org/-/scassets/images/org/health/articles/21648-heart-conduction-illustration

• Heart Rhythms seen on an EKG
• (ECG and EKG are the same thing, EKG comes from Elektrokardiographie which is Electrocardiogram (ECG) in German)
• The P wave is the contracting of the Atria
• The Q wave shouldn’t be seen or should be very small
• when the Q wave is visible it is a sign of heart damage
• The R/S wave is the contraction of the Ventricles
• The T waves is the resetting of the Ventricles
• The Atria also reset, but that can not be seen on an EKG due to the contracting

of the Ventricles, the Atria resetting is hidden

​

Images obtained from: https://www.aclsmedicaltraining.com/wp-content/uploads/2021/09/ACLS-Figure-30.jpg

• Common Heart Rhythms:
• Normal Sinus Rhythm
• Atrial Fibrillation
• Ventricular Fibrillation
• Ventricular Tachycardia
• Asystole
• When watching medical show, people that

have no heartbeat are “shocked”. The only

rhythms that can be shocked are

• Ventricular Fibrillation
• Ventricular Tachycardia
• Shocking rearranges electrical activity. When

someone is Asystole, they don’t have any

electrical activity to rearrange - so shocking

does’t work. The next time you watch a

medical show, see if they shock Asystole

​

Images obtained from: https://www.aclsmedicaltraining.com/wp-content/uploads/2021/09/ACLS-Figure-30.jpg

chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/http://keymedinfo.com/site/667KeyM/Cardiac_Dysrhythmia_Overview_to_help_with_ACLS_Precourse_Examination.pdf

https://apps.media.unc.edu/crashcart/Resources/images/VentricularTachycardia-01.png

​

PQRST can be seen

No P’s, just fibrillation - the atria jiggling like jello (causes the formation of clots)

No P’s, ventricles jiggling like jello

No P’s, wide and ugly

No electrical activity - technical death

Hands-on Activity Instructions

• 2-3 students per group
• Have students bring in the beverages they want to test.
• Lab Packet with instructions and questions

​

​

What Causes Dehydration?

• Loss of fluid that is not being replaced due to:
• Exercise
• Fever
• Heat
• Vomiting
• Diarrhea
• Excessive burns
• Kidney failure
• Certain medications

​

​

Why is Dehydration Dangerous in Children?

• Can change heart rate
• Can change blood pressure
• Can change mental status
• Can cause lethargy (sleepiness)
• Can cause organ failure

Hospitals Administering Fluids in Children

4 - 2 - 1 rule

​

1st hour:

4 mL / Kg

​

2nd Hour:

2 mL / Kg

​

Maintenance:

1 mL / Kg

No more than 100 mL per hour

​

Image obtained from: https://media.istockphoto.com/id/507271650/photo/intravenous-drip.jpg?s=612x612&w=0&k=20&c=X0XswHh4SCB_xG4jetpQshN0M1JOzxC5BEQ2Pav_cEU=

IV placement

• IV placed in superficial vein (veins go to the heart)
• Gives body fluids without the risk of vomiting
• Can be administered quickly (in relation to oral fluids)
• Can have vitamins and other beneficial additives added
• Normal Saline solution is 0.9% Sodium Chloride
• Human blood is about 0.8% Sodium Chloride

Image obtained from:https://nursemegrn.com/wp-content/uploads/2021/09/IV-insertion.png

https://www.emra.org/siteassets/emresident/images/articles/2020/06/47-3-us-guided-iv.png?w=600

Scenario

A 6 year old child has been vomiting for the past 3 days and is unable to keep any fluids down. He has not urinated in the past 24 hours. His mother brings him to the ED of the local hospital. He weighs 52 pounds. How much normal saline solution would he receive in the first hour? Second hour? Maintenance until the doctor deems him well enough to go home?

IV Calculation Scenarios

IV Calculation Scenarios - Answers

Solution

52 pound child

​

52 / 2.2 = 23.636 kg

​

23.636 x 4 = 94.544 mL for the first hour

​

23.636 x 2 = 47.272 mL for the 2nd hour

​

23.636 x 1 = 23.636 mL for maintenance each hour

​

​

​

To convert pounds to kilograms, divide the pounds by 2.2

Assessment

1. What is dehydration?

​

​

1. When someone has hyponatremia, what are they lacking?

​

​

1. What are things that cause dehydration?

​

​

1. What are the lasting effects of dehydration?

​

​

1. A 13 year old female was lost at sea for 8 days in 85 degree temperatures. When she was found she was dehydrated with peeling lips and was disoriented. She was 145 pounds. She was found by the coast guard and taken to the ED for evaluation and treatment. How much Normal Saline would she be given in the first hour, second hour, and for maintenance per hour?

​

​

1. A 6 year old male has congenital liver disease and was prescribed a diuretic to reduce edema in his ankles and trunk. His caregiver thought that his dose was 60 mg per day, but it was really 10 mg per day. He is extremely dehydrated and went to the ED. He is 55 pounds. How much Normal Saline would he be given in the first hour, second hour, and for maintenance per hour?

Assessment

Assessment answers

Differentiation

• Teacher does experiment as a demonstration with student participation.
• Use a student aide.
• Pair with an advanced student for practice problems.
• Use of videos (from Teacher Background Knowledge).

Remediation

Extension/Enrichment

• Pair with a student that needs help.
• Have student do the experiment as a demonstration.
• Have student explain IV calculation to the class.