Monday, October 7, 2013


renee thompson, rtconnections, clinical practice

When the temperature heats up or during flu season, some patients are more at risk for dehydration.  Who’s at risk?  To answer this correctly, you need to understand how the body maintains fluid balance.
Who has more water in their body – men or women; the elderly or babies?
To answer this question, you have to understand this…

Men versus women - Muscle has more water than fat and since males have more muscle than females, men have more water in their bodies.
Elderly versus babies - the younger you are, the more water you have.

Thus, it’s your elderly female patient who is the most at risk for dehydration.

How do you know if your patient is dehydrated? 
1.    Check a weight – This is a great, non-invasive way to determine if a patient is overloaded or dehydrated. Once their baseline weight is established, it’s the trending up or the trending down that can indicate a shift in fluid status. Check a weight daily.
2.    Physical assessment – Look at your patient.  Are their mucous membranes dry and cracked? Do they look dry? Although we’ve all been taught to check skin turgor, this might not be a good idea for your elderly patient with frail skin. 
3.    Check serum osmolality - This tells you how “thick” the blood is. Normal is 275 – 295mOsm/l. The higher the number, the dryer the patient, indicating the need for fluids.

If you suspect your patient is dehydrated, make sure the appropriate tests are ordered and that the patient has the proper fluids on board.

Remember, nurses are the key to preventing, early detection and management of dehydration. Don’t wait until your patient’s pressure drops to nothing to respond!

Thanks so much for reading. Take care and stay connected.

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