From the Guidelines
To monitor for signs of dehydration, regularly check for decreased urine output, sunken eyes, dry mouth, and other key indicators, as dehydration can lead to life-threatening illness and death, especially among the young and older adults 1. Dehydration occurs when the body loses more fluids than it takes in, disrupting normal bodily functions. Additional signs to watch for include:
- dark yellow urine
- fatigue
- dizziness
- confusion
- rapid heartbeat
- decreased skin elasticity (skin that doesn't bounce back quickly when pinched) For mild dehydration, encourage fluid intake with water or electrolyte solutions like Pedialyte or sports drinks. Adults should aim for 2-3 liters of fluid daily, while children need amounts appropriate for their weight, with a daily parenteral water requirement of 25-35 mL/kg, approximately 2.0-2.5 L for well-hydrated individuals 1. Severe dehydration requires immediate medical attention, especially if accompanied by extreme thirst, no urination for 8+ hours, disorientation, or rapid breathing. Dehydration is particularly dangerous for infants, elderly people, and those with chronic illnesses, as their bodies have less reserve capacity to handle fluid losses from vomiting, diarrhea, fever, or inadequate fluid intake. It is essential to monitor condition and advise individuals to return to the clinic if they continue to pass many stools, are very thirsty, have sunken eyes, have a fever, or do not generally seem to be getting better 1. Monitoring for signs of dehydration and adjusting fluid supplementation is crucial to prevent chronic renal failure in patients on home parenteral nutrition (HPN) 1.
From the Research
Monitoring for Dehydration
To monitor for signs of dehydration, such as decreased urine output, sunken eyes, and dry mouth, it is essential to understand the importance of hydration management. According to 2, optimal hydration is crucial to health, and suboptimal hydration can exacerbate common health problems in older adults.
Signs of Dehydration
Some key signs of dehydration include:
- Decreased urine output
- Sunken eyes
- Dry mouth These signs can be indicative of mild to moderate dehydration, which can be treated with oral rehydration solutions (ORS) 3, 4, 5.
Oral Rehydration Solutions
ORS are widely used for rehydration in diarrheal illness and to maintain hydration during vigorous exercise. The preferred ORS is one similar to the glucose-containing reduced osmolarity World Health Organization ORS 6, 5. Other solutions, such as polymer-based solutions using rice or wheat as the source of carbohydrates, are not widely recommended 6.
Hydration Management
Understanding dehydration and providing essential interventions to prevent it is crucial, especially in older adults 2. Hydration management involves assessing risk and providing interventions to prevent dehydration, which can help prevent common health problems such as falls, adverse medication events, and urinary tract infections.