9.7 Dehydration

Question 1

Nursing Assessment for Dehydration

Answer 1

• I/O
• Concentrated Urine Color
• Decreased Output
• High urine specific gravity

Output - Typically 1 mL/kg/hr (less is dehydration)

Weight - Decreased weight

Skin - Decreased turgor (tented)

Mucous Membranes - Dry
- May not have any tear production

Sunken Fontanels

• Tachycardia, Tachypnea
• Decreased LOC (slightly disoriented)

Electrolyte Imbalance (serum sodium will increase and potassium will decrease because sodium and potassium are inverse of each other)
- During rehydration make sure you don’t over hydrate them and dilute electrolytes.

Question 2

Hyponatremia

Answer 2

• Monitor for hyponatremia because overhydrating can dilute their sodium

Symptoms
- Headache, N/V
- Neurological (confusion, delirium, irritability, lethargy, decreased LOC)
- Convulsions, coma, apnea

Question 3

Hyper/Hypokalemia

Answer 3

Hyperkalemia (kidney not excreting potassium as it should)
- Muscle weakness (changes in muscle control)
- Cardiac (irregular heartbeat)
- Slow, weak, absent pulse

Treatment - Kayexalate (sodium polystyrene sulfonate) - Helps to lower potassium 4-6 hours after administration.

Hypokalemia
- Replace potassium through IV fluid or IV piggyback
- NEVER GIVE POTASSIUM TO PATIENT BEFORE CHEKING KIDNEY FUNCTION (because it is excreted by kidneys) - Make sure they have adequate urinary output.

Question 4

Signs of Dehydration

Answer 4

• Sunken fontanelles
• Absence of tears
• Sunken eyes
• Sticky/Tacky oral mucosa
• Delayed capillary refill
• Reduced skin turgor
• Inactivity/Lethargy
• Tachycardia
• Hypotension