Dehydration

Definition

Dehydration is a state of negative fluid balance from excessive water loss or inadequate intake. It can be isotonic, hypertonic, or hypotonic depending on accompanying electrolyte losses.

Causes

• Vomiting, diarrhea, fever, sweating
• Diuretics, inadequate intake
• Burns, hemorrhage
• Uncontrolled diabetes (hyperglycemia, DI)

Signs and Symptoms

Decreased skin turgor (tenting), dry mucous membranes, sunken eyes, tachycardia, orthostatic hypotension, oliguria, increased urine specific gravity and osmolality, elevated BUN/creatinine ratio (>20:1), hemoconcentration (elevated Hct/albumin). In infants: sunken fontanels, decreased tears, fewer wet diapers.

Nursing Interventions

Administer oral rehydration solutions (ORS), hypotonic or isotonic IV fluids per order, monitor daily weights, I&O, vital signs, and electrolytes. Assess mental status. Educate at-risk populations (elderly, athletes, children) on preventive hydration.

NCLEX Relevance

Pediatric dehydration: sunken fontanels, fewer wet diapers per day are key cues. Daily weight is the most accurate measure of fluid status.