Dehydration

Introduction:

A state of having less-than-normal body fluids, due to an excess loss of fluids or
an inadequate intake of fluids. Dehydration may be actual or relative. A relative
dehydration exists when the amount of fluid and electrolytes in the body is cor-
rect, but the placement is not correct. If fluid shifting has occurred and the fluid
is now in the interstitial areas rather than in the circulating blood volume, the
patient may actually be experiencing a relative dehydration. Even though there is
adequate fluid within the body, it cannot be utilized at this time. More commonly,
dehydration is actual and due to loss of fluid from the body or lack of adequate
hydration.

PROGNOSIS
Adequate replacement of fluids with the appropriate fluid type is essential to ensure
adequate circulating blood volume.


SIGNS AND SYMPTOMS

• Thirst as the body wants more fluids
• Poor skin turgor due to fluid loss
• Tachycardia—heart rate increases to circulate remaining volume faster
• Tachypnea—respiratory rate increases in an attempt to obtain more oxygen
• Decreased urinary output—less volume available to leave the body
• Increased BUN as volume depletes
• Hypotension due to decrease in circulating blood volume

TREATMENT

• Intravenous and oral fluid replacement.
• Monitor serum electrolytes, BUN, creatinine, urine electrolytes.
• Monitor cardiac rhythm if there is an electrolyte disturbance.

NURSING DIAGNOSIS
• Deficient fluid volume
• Risk for impaired urinary elimination

NURSING INTERVENTION
• Monitor vital signs; check for orthostatic hypotension.
• Monitor intake and output.
• Assess intravenous access site for signs of redness, swelling, or pain.
• Assess skin and mucous membranes for dryness.
• Assess cardiovascular status—heart rate, heart sounds, peripheral pulses.
• Assess respiratory status—lung sounds, respiratory rate.
• Encourage oral fluid intake.
• Increase frequency of mouth care.
• Impaired oral mucous membrane