Dehydration can cause a variety of symptoms ranging from mild to severe. Mild dehydration may cause increased thirst, dry mouth, and weakness while severe dehydration can lead to confusion, fainting, and decreased urine output. It is important to assess vital signs, skin moisture, mucous membranes, and urine output to determine the severity of dehydration. Intravenous fluids should be administered and output monitored closely to rehydrate the patient and stabilize their condition. The cause of dehydration must also be investigated which can be due to various issues like gastroenteritis, burns, or diabetes.

1. Dehydration
Krizza Anne C. Bucok, RN

2. CLINICAL PICTURE

3. The patient may have
• Increased thirst, dry mouth, swollen
tongue
• Weakness, dizziness, palpitations
• Tachycardia, hypotension
• Confusion, sluggishness, fainting, seizu
re
• Decreased urine output

4. IMMEDIATE INTERVENTIONS

5. • Assess VS
– Check BP lying, sitting, standing
– Note changes
• Assess current urine output and recent
I&O
• Make sure patient is comfortable and
safe
• Notify physician

6. • Document the following:
– Patient’s status
– Phone call to physician or NP
– Physician or NP response

7. FOCUSED ASSESSMENT

8. Assess:
• VS including temperature
• Skin for
color, moistness, temperature, integrity
• Mucous membranes
• LOC and orientation
• For patent IV access

9. STABILIZING AND
MONITORING

10. • Administer or oral IVF
• Closely monitor I&O
• Monitor urine output for adequate
hourly rate
• Assess electrolytes, BUN, creatinine
• Maintain safe environment
• Provide oral care
• Chart patient status and convey to
physician or NP

11. BE PREPARED TO

12. • Obtain IV access
• Obtain a nutritional/dietary assessment
• Insert a urinary catheter with a urometer
to monitor hourly output

13. POSSIBLE ETIOLOGIES

14. • Gastroenteritis • Gastrointestinal
• Stomatitis obstruction
• Diabetic • Heat stroke
ketoacidosis • Diabetes insipidus
• Febrile illness • thyrotoxicosis
• Pharyngitis
• Burns

15. Signs and Symptoms of Progressive
Dehydration
Moderate
Symptom/sign Mild Dehydration Severe Dehydration
Dehydration
LOC Alert Lethargic Obtunded
Capillary refill 2 sec 2-4 sec >4 sec, cool limbs
Mucous membranes Normal Dry Parched, cracked
HR Slight increase Increased Very increased
Increased and
RR Normal Increased
hyperpnea
BP Normal Normal but orthostasis Decreased
Pulse Normal Thready Faint or impalpable
Skin turgor Normal Slow Tenting
Urine output Decreased Oliguria Oliguria/anuria