Sugar and water

Hello 30days2nclex,

Did you mean where salt goes water follows?

I used Hurst as well...which section/topic are you referring to? Thanks!

Are you thinking of osmosis and diffusion?

Are you referring to DKA ... Water will follow sugar (and salt) ...you want to prevent dehydration.

They easily could have meant salt. The guide you are referring to is helpful but is not 100% correct. But, if they truly meant sugar then I believe that BrittyRN is right. If they truly meant sugar they were probably referring to high levels of glucose in the blood which we know will cause polyuria. Therefore, "where sugar goes water follows."

OK thank you so much. That makes since. I'm just thinking of my self now. I am not diabetic but if I consume a lot of sweets I start to pee a lot. So I get it noe where sugar is water follows. OK do you think this is the same with salt? If a patient has a lot of salt in their system....I would think that it would be the opposite ....I once knew a lady that when ever she would drive long distance trips she would eat a lot of high sodium foods like chips and stuff because she said it help her not pee as much on the road. What do you think?

Yes, I would agree with that. When you take in a lot of sodium you RETAIN water. That is why patients with HF are to restrict the amount of sodium in their diets. Too much sodium=too much water=fluid overload.

Sodium=edema.

This is a chemistry problem, which you can understand if you go back to what you learned about diffusion. Remember the semipermeable membrane? Remember that water goes from an area of lower concentration of solutes to an area of higher concentration of solutes? (That's "water travels.")

What that means is that if there is a lot of sugar on one side of a semipermeable membrane, like a cell wall, and less on the other side, the water on the less-concentrated side will move through the membrane to try to make concentrations on both sides equal. If you put RBCs in D50W, they'll shrivel right up as their water leaves them to try to equilibrate the concentration of solutes on both sides of the cell membrane.

What this means in diabetes, for example, is that a really high blood sugar will pull water out of the cells, all cells, resulting in cellular dehydration. The kidneys will pee it all out, water and sugar both, making for a lot of sweet urine. Diabetes mellitus means sweet urine, you know that? Ancient physicians used to test urine by tasting it; more modern physiologists noticed that there were more ants in the urine of kenneled diabetic dogs. There ya go.

Water loss [say, because kidneys have lost their ability to concentrate urine (various chemicals will do this, including alcohol, briefly, and lithium, permanently) and let too much water leave in the urine, or because kidneys can't hold onto water because of the high sugar content in it in diabetes is pulling it out] causes hypernatremia because the concentration of sodium goes up when you remove water. Hypernatremia pulls even more water out of the cells through the same diffusion as above.

Does that make sense?

This is a chemistry problem, which you can understand if you go back to what you learned about diffusion. Remember the semipermeable membrane? Remember that water goes from an area of lower concentration of solutes to an area of higher concentration of solutes? (That's "water travels.")

What that means is that if there is a lot of sugar on one side of a semipermeable membrane, like a cell wall, and less on the other side, the water on the less-concentrated side will move through the membrane to try to make concentrations on both sides equal. If you put RBCs in D50W, they'll shrivel right up as their water leaves them to try to equilibrate the concentration of solutes on both sides of the cell membrane.

What this means in diabetes, for example, is that a really high blood sugar will pull water out of the cells, all cells, resulting in cellular dehydration. The kidneys will pee it all out, water and sugar both, making for a lot of sweet urine. Diabetes mellitus means sweet urine, you know that? Ancient physicians used to test urine by tasting it; more modern physiologists noticed that there were more ants in the urine of kenneled diabetic dogs. There ya go.

Water loss [say, because kidneys have lost their ability to concentrate urine (various chemicals will do this, including alcohol, briefly, and lithium, permanently) and let too much water leave in the urine, or because kidneys can't hold onto water because of the high sugar content in it in diabetes is pulling it out] causes hypernatremia because the concentration of sodium goes up when you remove water. Hypernatremia pulls even more water out of the cells through the same diffusion as above.

Does that make sense?

I knew you would smell the salty-sweetness of this thread.