2. Water Intoxication News Report   HEADLINE: Jail death from excess water drinking raises questions (May 23, 2016)   Ruben Nunez’s stay in San Diego’s Central Jail this past August was supposed to be short, less than a week, for a court hearing to determine whether psychiatrists at Patton State Hospital in San Bernardino could continue to involuntarily medicate him. Five days after he arrived at the jail, Nunez, 46, was dead from a psychiatric condition known as psychogenic water intoxication, or psychogenic polydipsia, that causes unrelenting thirst and can go hand-in-hand with serious mental illness. Sufferers drink water uncontrollably, sometimes to the point of death. Nunez’s death, one of 12 in San Diego jails in 2015, raises questions about whether staff failed to properly monitor him. Nunez, who grew up in San Diego, was diagnosed with schizophrenia as a teenager, according to his mother, Lydia Nunez. When he was taking his medication, he could be friendly and outgoing, she said. Off medication, he sometimes turned violent. His psychiatrics, Dr. Nazem Ghobrial at Patton, stated, “He refuses to accept that he has a mental illness or needs to be treated for it, he also showed symptoms of psychogenic water intoxication.” At Patton, Nunez sometimes required constant monitoring to ensure he didn’t drink water to excess, the declaration says. “He is not able to recognize why this is of concern,” Ghobrial wrote. “Without treatment this could have easily killed him.” Less than five days after being transferred from Patton to the Central Jail, Nunez was found unresponsive in his cell. According to his autopsy report, he had cerebral edema.   a) Explain how excess water drinking, in relation to serum osmolality, led to cerebral edema.

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2. Water Intoxication News Report

 

HEADLINE: Jail death from excess water drinking raises questions (May 23, 2016)

 

Ruben Nunez’s stay in San Diego’s Central Jail this past August was supposed to be short, less than a week, for a court hearing to determine whether psychiatrists at Patton State Hospital in San Bernardino could continue to involuntarily medicate him.

Five days after he arrived at the jail, Nunez, 46, was dead from a psychiatric condition known as psychogenic water intoxication, or psychogenic polydipsia, that causes unrelenting thirst and can go hand-in-hand with serious mental illness. Sufferers drink water uncontrollably, sometimes to the point of death.

Nunez’s death, one of 12 in San Diego jails in 2015, raises questions about whether staff failed to properly monitor him.

Nunez, who grew up in San Diego, was diagnosed with schizophrenia as a teenager, according to his mother, Lydia Nunez. When he was taking his medication, he could be friendly and outgoing, she said. Off medication, he sometimes turned violent.

His psychiatrics, Dr. Nazem Ghobrial at Patton, stated, “He refuses to accept that he has a mental illness or needs to be treated for it, he also showed symptoms of psychogenic water intoxication.”

At Patton, Nunez sometimes required constant monitoring to ensure he didn’t drink water to excess, the declaration says.

“He is not able to recognize why this is of concern,” Ghobrial wrote. “Without treatment this could have easily killed him.”

Less than five days after being transferred from Patton to the Central Jail, Nunez was found unresponsive in his cell. According to his autopsy report, he had cerebral edema.

 

a) Explain how excess water drinking, in relation to serum osmolality, led to cerebral edema.

 

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