Dry?

TheCommuter, BSN, RN · Nov 26, 2015

More context is needed to properly answer this question...

For instance, those of us who regularly work with end-stage renal disease patients on dialysis are asked the "dry" question by the physician. It is shorthand for, "So the patient's not retaining more fluid than usual?" or "Is that a dry weight?"

However, since I do not know what types of patient populations you work with, I can only guess what the doctor is talking about.

RNperdiem, RN · Nov 27, 2015

Depends on where you work. In surgery, it has to do with fluid balance. Used in conversation: "transplant docs like to keep their liver patients on the dry side". Dry is the opposite of fluid overload. It can be a deliberate choice, or a patient that needs some bolusing.

Donna 1966 · Nov 27, 2015

I work telemetry floor, so it can be just about any type of patient. Specifically my patient who just had IV lopresser about 2 & 1/2 hours ago went back into sinus tach verified by EKG. When he ask if the patent was dry. Basic Hx DM CVA, admitted with UTI

Sun0408, ASN, RN · Nov 27, 2015

The doc was asking if the pt needed more fluid as in a bolus. Usually pts are "dry" when they are dehydrated, not getting enough fluid, had surgery etc.

Sun0408, ASN, RN · Nov 27, 2015

OP, since you brought it up and we have answered your question. Here is a little homework for you, what labs should you look at to see if your pt is dry??

Donna 1966 · Nov 27, 2015

Maybe that is the true question I'm asking. Bun creatinine or elevated Na and K are normal. Been running NS at 150 for more then 12 hours. No labs redrew for more then 14 hours.

What else would I need to look for, other then the outwardly signs of dehydration?

martymoose, BSN, RN · Nov 27, 2015

What else would I need to look for, other then the outwardly signs of dehydration?

An order for labs!

well just kidding, but not really.

Is there more PMH on pt? as in are they elderly, heart failure hx,ETOH, Renal hx.

Are they ill headed toward sepsis?

Look for urine output. If dry , depending on why, they will have a bit of catching up to do, but they should still be putting out the minimum per hour- usually >30 cc/hr. So strict I and Os

Check B/P trends- if its still trending down after being "hydrated" something is wrong

Mentation.

If cardiac, look for rales, o2 sats dropping,leg edema.( these would be fluid overload)

Sometimes sepsis is difficult in cardiac/renal pts. They need the fluids, but cant process them . Its a very fine line.

Im told ETOHer are chronically dehydrated.

HTH :)

BuckyBadgerRN, ASN, RN · Nov 27, 2015

I work in ophthalmology, in retina where we deal with age-related macular degeneration. Wet or dry is the difference between the patient getting an intravitreal injection today or not.

Christy1019, ASN, RN · Nov 27, 2015

I agree with all of the above responses. If the doctor asked me that given the scenario you presented, I would assume they were asking if the pt was showing signs of dehydration. Also, you said your pt has DM, what is their glucose? Do they have polyuria? That's an easy way to become dehydrated despite being on fluids.

What is their BP? Is the elevated BUN/Creatinine a new finding or is this baseline for this pt? Is the pt alert and able to drink fluids?

Do they have a fever? Any signs of sepsis related to the UTI?

mmc51264, BSN, MSN, RN · Nov 27, 2015

We have pts that go to the OR "dry". For our ortho pts, they do not go to sx dry as they tend to lose a little more blood. Took me a while for me to figure that out. All out pts that are NPO are automatically put on fluids, Other services do not order fluids for NPO pre-op pts