Simply Dehydration

[Tolle_lege]

I have a client that was recently hospitalized from our DDN-ICF facility. The labs showed a critically high sodium level of 169, and some other labs off a little. Serum Creatinine is 1.09, BUN is 22 (not really high, but more than her usual of 8-10 on other labs this year.) I may repost later with other numbers, (don't have all the paperwork in front of me!)

The MD at the hospital says dehydration, so they give her IV fluids, 75ml/hr NS from Friday night until thursday morning, now they switched to 100ml/hr D5, but her sodium after a week is still 148 per labs yesterday morning. I asked about her I and O s and she's 2500 in and 1600 out, with a little loose stools.

This client is not verbal, so not able to express any subjective information. However she takes all fluids that were offered to her in the facility which is about 1500 a day orally with thicket + what is added her pureed food, was told by state nurse that 1500 was minimal and she needed to be offered more because she is dehydrated, so it will be a deficiency.

My question is: If this is just dehydration, wouldn't IV fluids have resolved it in a two days or less? Any ideas? I'm a brand new nurse just trying to make sense of my little "mystery". :) Thanks in advance.

[Tolle_lege]

When my client came back from the hospital there was Chronic Kidney disease listed on the problem list, and her eGFR was around 40-44 for several days. I did not get a copy of the labs done on the day that she was discharged, however the notes said that it was "resolved" Is this common to resolve kidney issue like this. I was under the impression that Chronic Kidney issues did not "resolve".

[Virgo_RN, BSN, RN]

You're right, CKD does not resolve, since as the name implies, it is chronic. However, ARF on CKD can resolve. Perhaps she had ARF on CKD, and it was the ARF that they considered resolved?