Hydration: Preventing Psychiatric and Physical Symptoms
As a Psychiatric Nurse Practitioner and Naturopath (ND), I am very concerned with my clients fluid replenishment. The human body eliminates approximately two liters of fluid in a day through perspiration and elimination. I have clients who come to see me for psychiatric evaluation and tell me they feel dizzy. As I mentioned in previous blogs, I try to keep everything simple (KISS). So, the first thing I ask my clients is, “how much water, and other fluids do you drink in a day?” (The second is – “How much sleep and rest have you had recently”– see my other blogs): It is important to replenish the two liters and then some to keep properly hydrated, so one needs to drink 8 cups of fluid, preferably, purified water.*
The first thing I do is take the person’s blood pressure – I take it on each client – at each visit. If a clients’ blood pressure, when seated, is significantly different (higher) than their blood pressure when they stand up, then, it could conceivably be the cause of the dizziness. This is called postural hypotension. The amount of fluid intake is one possible explanation for this problem, of course there are others. Another simple explanation, is: Does the client have a diagnosis of Hypertension? Then, I would look at how my client is taking his/her medications. Since blood pressure fluctuates, some people take their medication, without checking their blood pressure and pulse. The problem is obvious. Take a “blood pressure pill” when your blood pressure is down and it could cause a number of symptoms including dizziness.
Of course there are other reasons for dizziness and their psychiatric medication could be causing it, but, I look at this as a cause when the patient has just started a medication or if the client has recently changed their “medication recipe” (what I call their medication regime).
Certainly, if I am not satisfied that the dizziness is not easily diagnosable, I will suggest further testing and may refer my client for further evaluation by their primary care practitioner or send the client to the urgent care clinic for evaluation.
Summary: A symptom of dizziness is a significant symptom, but it is prudent to look at possible simple causes. Of course dizziness must be evaluated to the satisfaction of the practitioner before the client leaves the office, with an appropriate treatment plan, but it is my firm belief that clients should have more control over their health so reviewing fluid intake and reviewing their sleep regime are two important methods of helping my clients to have an impact on their good health.
* http://www.cnn.com/HEALTH/library/NU/00283.html
The first thing I do is take the person’s blood pressure – I take it on each client – at each visit. If a clients’ blood pressure, when seated, is significantly different (higher) than their blood pressure when they stand up, then, it could conceivably be the cause of the dizziness. This is called postural hypotension. The amount of fluid intake is one possible explanation for this problem, of course there are others. Another simple explanation, is: Does the client have a diagnosis of Hypertension? Then, I would look at how my client is taking his/her medications. Since blood pressure fluctuates, some people take their medication, without checking their blood pressure and pulse. The problem is obvious. Take a “blood pressure pill” when your blood pressure is down and it could cause a number of symptoms including dizziness.
Of course there are other reasons for dizziness and their psychiatric medication could be causing it, but, I look at this as a cause when the patient has just started a medication or if the client has recently changed their “medication recipe” (what I call their medication regime).
Certainly, if I am not satisfied that the dizziness is not easily diagnosable, I will suggest further testing and may refer my client for further evaluation by their primary care practitioner or send the client to the urgent care clinic for evaluation.
Summary: A symptom of dizziness is a significant symptom, but it is prudent to look at possible simple causes. Of course dizziness must be evaluated to the satisfaction of the practitioner before the client leaves the office, with an appropriate treatment plan, but it is my firm belief that clients should have more control over their health so reviewing fluid intake and reviewing their sleep regime are two important methods of helping my clients to have an impact on their good health.
* http://www.cnn.com/HEALTH/library/NU/00283.html
posted by Eric Malz at 3:28 AM
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