The Level of Dehydration Experienced in Patients - Research Paper Example

? Methods Paper: Dehydration associated with the use of Diuretics Research Design The research design that will be utilized in this study is the quasi-experimental study design aimed at evaluating the scale of difference in performance as a result of any intervention (Hccedl.cc.gatech.edu, 2004). In this study the design is meant to determine if the use of diuretics influences the level of dehydration experienced in patients. Quasi-experimental design involves the use of control and treatment groups in the experiment where one group uses the diuretic drugs, while another, which is the control group does not use the diuretics, and then a measurement on the level of dehydration is taken to determine the difference (Cook & Campbell, 1979). The design also involves administration of pre and post examination test to measure the fluid levels among the participants (Nationaltechcenter.org, 2013). For this study, a non-equivalent control-group design will be used to allow the researcher to compare the measurements of treatment group with the measurements recorded by the control group. This is intended to determine if there is a variance in in the level of dehydration that can be associated with the administration of diuretics. The control group in this study will be a group of 40 patients suffering from hypertension, who will not be allowed to use diuretics for a controlled period of time within the acceptable medical standards. A pretest will be done on them to measure the level of hydration before the experiment is done and a posttest carried out later. Treatment group in this case will involve another group of 40 hypertension patients who will undergo pretest to measure their level of hydration, then issued with diuretic tablets. A posttest examination will then be carried out on the treatment group to determine level of dehydration. These results are to be compared with the recording from the control group for the researcher to find out any connection between the dehydration to the administration of diuretics (Sheps, 2011). This will either confirm or refute the hypothesis. Diagram 1 The chart above shows a four staged process that begins from points A and B through to the comparison of results. Sample and Setting This study will involve a sample size of 80 patients suffering from high blood pressure and are between age 40 and 55. The sample size will be divided into two groups, one being a control group and the other being treatment group. This group of people was chosen because of their health condition and the fact that people with hypertension conditions are medically allowed to use diuretics under prescription of the doctors to help them lose fluids that are retained as a result of their conditions. The study will be carried out at Agha Khan Hospital during clinics schedules in collaboration with the hospital’s administration and the doctors’ guidance. The choice of this setting is influenced by the high turnover number of the blood pressure patients who visit the hospital on a daily basis and the availability of doctors to monitor the control group in case of any effect as a result of the planned temporary deprivation of diuretics. Description of the Power Analysis This study used G Power software for the power analysis. This helps to avoid trial-and-error method of finding a sufficient sample size, G Power allowed imputing the desired power of 0.8 as directed together with the given alpha value, which is 0.5 and expected effect size of 0.3 to generate the minimum sample size needed. The power analyzed here gives the probability of whether to accept or reject the null hypothesis. It should be noted that effect size is of 0.3 indicates that there was a small effect. The alpha of 0.5 shows the error or 95% confidence level in the data used or that the researcher is willing to accept a possibility of a 5% chance in the results. Quasi experiments control the intervening variables, since there is a controlled administration of the diuretics to two groups. Dehydration is the dependent variable in this case since most patients suffering from fluid retention complications depend on the administration of the drug to release the excess fluids from their system. Diuretics in this case are the independent variables that are not influenced by the level of fluids. Quasi experiments ensure there are distinct control groups and the treatment groups that are separated by the rules of engagement in order to reach the intended results. These two groups only converge after post-test examination while comparing the measurements recorded in the two groups. This means that no process, whether A, or B influences the outcome of another. During the experiment, are to be taught by the researcher to take equal quantity of fluids as advised by the doctor to provide approximately uniform fluid content. Equally, the patients are taught on the effects of overusing the diuretics with intentions to reduce body weight. Co-operation of the patients is vital to the success of this study. To achieve this, making the patients to own the exercise as part of their training in the management of their high blood pressure condition will go a long way in engaging them. Clear communication at the beginning of the experiment to make them aware that overdose of the drug leads into more serious effects such as kidney damage, heart palpitations, cardiac arrhythmias, electrolyte imbalance, salt imbalance, potassium deficiency, fluid retention, dizziness, constipation and dry eyes as well as death may occur (Best-Boss, 2008; Pickkers, 2000).This is a theory of activation that ensures that patients take charge of their well-being and become active in any activity meant to improve their situation. Measurements An independent variable in an experiment is a factor that can be manipulated by the experimenter to check if it can influence the response of other factors.This helps the experimenter to determine whether or not subjects are dependent on the independent variable. For example in this study, a diuretic is the independent variable which the researcher administers to see if it affects the dehydration.A dependent variable on the other hand is a factor in an experiment monitored to determine whether the alteration of the independent variable affects its response (Rosenthal & Rosnow, 1991). In this study, dehydration is the dependent variable which arises as a result of the administration of a independent variable (diuretics). Dehydration is the excessive fluid loss from body tissues that can lead to an imbalance in essential electrolytes, such as sodium, potassium, and chloride (Batmanghelidj, 2003). This can be caused by normal body excretion or as a result of the use of diuretic drugs and can lead into much severe effects (Webmd.com, 2013). How Measurement will be done The patients’ dehydration level will be measured through weight monitoring using scale during the pretest and posttest to check any loss, gain of wait of before and after administration of diuretics for the treatment group. Urine output will also be measured to gauge the amount or urine released as a result of the diuretics compared to the urine collected from the control group. A cuff is also used to measure the blood pressure (BP) showing the systolic and diastolic measurements (Bloodpressureuk.org, 2008). Lower BP after administration of diuretics as compared to the control group show loss of fluids in the arteries. The measurements attained are very valid, reliable and their collection very practical. This is because in the clinics, every blood pressure patient must be examined their weight and blood pressure before drugs are prescribed (Fahey, Murphy & Hart, 2004). This determines if they are to be put on rest or to be discharged. The BP measuring hand cuff in Agha Khan Hospital produces accurate results of the systolic and the diastolic pressure. The reliability is gaged by the fact that measurement is done before and after the patients are put on drugs. The guidance of a qualified doctor at the clinic adds to the validity and reliability of the measurements. The measurement level used in this study is the internal measurement. This is because the data is arranged in interval of ideal blood pressure, pre-high blood pressure and high blood pressure. The differences between the intervals make sense for the analysis of the effects of using diuretics. That is measurements falling above 120/80 cross to the next level of pre-high blood pressure. The validity and practicability is further explained in the BP scale below; Control Group(Posttest) BP scale Treatment Group (Posttest) BP Scale A 122/82 A 100/70 B 121/83 B 110/75 C 126/87 C 92/62 D 130/90 D 96/66 E 128/88 E 100/68 F 123/84 F 120/80 G 123/84 G 115/75 H 122/80 H 118/78 I 140/90 I 112/72 J 138/89 J 110/76 K 139/89 K 120/80 L 142/91 L 116/76 M 140/90 M 119/79 N 143/91 N 118/78 O 120/80 O 120/80 Table 1: BP scales The blood pressure table above shows two readings in the scale. This was taken during the posttest, after administration of diuretics for the treatment group and no administration of the drugs for the control group. Blood pressure readings indicate two numbers, for example 122/82 for patient A in the control group category.The top numbersrepresent the patients’ systolic BP while the bottom numbers represent the diastolic blood pressure (Bloodpressureuk.org, 2008). It should be noted that the blood pressure recordings for the control group showed pre-high pressure above the normal 120/80 because of the fluid retention and failure of taking diuretics. Blood pressure for the treatment group was ideal within the right range as a result of the administration of diuretics (Kowalski, 2007). This recording was done for all the 80 participants and including the weight check and the amount of urine collected during the period. Conclusion Dehydration is also associated with the use of diuretics especially among the high blood pressure patients (Pickkers, 2000). This conclusion was arrived at after conducting a study involving 80 hypertension patient at Agha Khan Hospital. Quasi experimental method was used that divided the sample into two groups consisting of 40 patients categorized in the treatment group and 40 in the control group. Dehydration is the dependent variable, while diuretics are the independent variable in the study. The measurement used to ensure validity; reliability and practicability are the BP hand cuff, weight check and urine collection. References Batmanghelidj, F. (2003). Water for health, for healing, for life: You're not sick, you're thirsty! New York: Warner Books/Hachette Book Group. Best-Boss A. (2008).Diuretic Effects. Retrieved on 17 March 18, 2013 from http://www.eatingdisordersonline.com/medical/diuretics.php Bloodpressureuk.org, (2008).Blood pressure chart.Retrieved on 17 March 18, 2013 from http://www.bloodpressureuk.org/BloodPressureandyou/Thebasics/Bloodpressurechart Hccedl.cc.gatech.edu, (2004).Quasi-experimental design. Retrieved on 17 March 2013 from http://hccedl.cc.gatech.edu/documents/119_Fisk_quasi- experimental%20design%202004.pdf Cook, T. D., & Campbell, D. T. (1979). Quasi-experimentation: design & analysis issues for field settings. Chicago: Rand McNally College Pub. Co.. Fahey, T., Murphy, D., & Hart, J. T. (2004). High blood pressure (3rd ed.). London: Class. Kowalski, R. E. (2007). The blood pressure cure: 8 weeks to lower blood pressure without prescription drugs. Hoboken, N.J.: John Wiley & Sons. Nationaltechcenter.org, (2013).Quasi Experimental Study.National Centre for Technology Innovation. Retrieved on 18 March 2013 from http://www.nationaltechcenter.org/index.php/products/at-research-matters/quasi- experimental-study/ Pickkers, P. (2000). Vascular effects of diuretics. S.l.: s.n.]. Rosenthal, R., & Rosnow, R. L. (1991). Essentials of behavioral research: Methods and data analysis (2nd ed.). New York: McGraw-Hill, Inc. Sheps, S.G., (2011). Can diuretics decrease your potassium level? Retrieved on 18 March 18, 2013 http://www.mayoclinic.com/health/blood-pressure/AN00352 Webmd.com, (2013). Dehydration in Adults. Retrieved on 18 March 2013 from http://www.webmd.com/a-to-z-guides/dehydration-adults Read More