Best assessment for dehydration

[nursingone]

Hi,

Can anyone tell me which is the best assessment on a client with dehydration and why?

a. potassium level

b. skin turgor

c. oral mucous membranes

Why is blood pressure measured in seniors to determine

dehydration problems? I would appreciate an answer.

thanks again

nursingone

[lilome]

Well, I wouldn't think potassium. Sodium is a better indicator. I guess between the three I would go with skin turgor. Oral membranes can dry out with a mouth breather. What was the fourth choice?

As for the second question their orthostatics would be off if you're dehydrated. Their more prone to more significant drops with fluid loss.

[mona b RN, BSN, RN]

Hi,

Can anyone tell me which is the best assessment on a client with dehydration and why?

a. potassium level

b. skin turgor

c. oral mucous membranes

Why is blood pressure measured in seniors to determine

dehydration problems? I would appreciate an answer.

thanks again

nursingone

I would go with skin turgor unless the client is very young, then I would think mucous membranes. I actually just had a question very similar to this while reviewing yesterday. Potassium would increase if a client is dehydrated because they are not excreting it through the kidneys.

[Johari]

I would go with the oral mucous membranes:

Rationale: Dehydration exhibits in addition to loss of skin tugor, longitudinal tongue furrows, sunken eyes, dry mucus membranes, upper body muscle weakness, speech difficulty and confusion.

I'm chosing oral mucous membranes assessment because skin tugor is different in different age groups. Elderly vs. Younger people etc... Just my two cents.

Though K+ is elevated in hypotonic dehydration (sodium loss > water loss) there isn't enough information in the question. What is the right answer?

Johari :)

[Johari]

Hi,

Why is blood pressure measured in seniors to determine

dehydration problems? I would appreciate an answer.

thanks again

nursingone

Hypovolemia can cause orthostatic hypotension. BP is measured in elderly to determine if they are dehydrated as indicated in their diastolic BP. It can be a confirmatory tool for quick nursing diagnosis for an already suspected diagnosis.

Johari :)

[mona b RN, BSN, RN]

i would go with the oral mucous membranes:

rationale: dehydration exhibits in addition to loss of skin tugor, longitudinal tongue furrows, sunken eyes, dry mucus membranes, upper body muscle weakness, speech difficulty and confusion.

i'm chosing oral mucous membranes assessment because skin tugor is different in different age groups. elderly vs. younger people etc... just my two cents.

though k+ is elevated in hypotonic dehydration (sodium loss > water loss) there isn't enough information in the question. what is the right answer?

johari :)

i did a search on "signs of dehydration" and came across this: http://www.saferchild.org/dehydrat.htm

mild dehydration: (increase fluid intake -- and for babies, call a medical professional): thirst, dry lips, dry mouth, flushed skin, fatigue, irritability, headache, urine begins to darken in color, urine output decreases

moderate dehydration: (call a medical professional): all of the signs of mild dehydration, plus: skin doesn't bounce back quickly when pressed, very dry mouth, sunken eyes, (in infant - sunken fontanel, the soft spot on the head), output of urine will be limited and color of urine will be dark yellow, cramps, stiff and/or painful joints, severe irritability, fatigue, severe headache

severe dehydration: (call emergency number): all of the signs of mild and moderate dehydration, plus: blue lips, blotchy skin, confusion, lethargy, cold hands and feet, rapid breathing, rapid and weak pulse, low blood pressure, dizziness, fainting, high fever, inability to pee or cry tears, disinterest in drinking fluid.

so my guess is that you should pick the first sign of dehydration, which, according to this source, would be mucous membranes:)

[2005grad]

I would go with the oral mucous membranes:

Rationale: Dehydration exhibits in addition to loss of skin tugor, longitudinal tongue furrows, sunken eyes, dry mucus membranes, upper body muscle weakness, speech difficulty and confusion.

I'm chosing oral mucous membranes assessment because skin tugor is different in different age groups. Elderly vs. Younger people etc... Just my two cents.

Though K+ is elevated in hypotonic dehydration (sodium loss > water loss) there isn't enough information in the question. What is the right answer?

Johari :)

You took the words right out of my mouth :)

faith

[Johari]

BTW... after further thinking.... the stem says assessment. I guess we eliminate checking K+ because this falls under intervention. What you do after you suspect to confirm that dehydration is probable is that you check labs etc to confirm... think Maslow's, basically you start simplest to more complex... another reason why I think oral mucous membranes is right. Critical thinking can be a bammer.... we are forced to go deeper. Anyway, good luck to everyone.. count down has began for me.

Johari :)

[nursingone]

Good morning,

Thank you to everyone that answered my questions. These questions are the kinds continue to confuse me but with this information provided; I will sort things out.

Thanks again and have a great day!

peace

nursingone