Signs and symptoms of dehydration

• The first symptom of dehydration is generally thirst.
• A dry and coated tongue is a strong indicator of dehydration. A client may find talking difficult due to the tongue sticking to the roof of the mouth.
• The client may have increased skin turgor and the skin can be dry and scaly in appearance.
• The eyes may appear shrunken into their sockets.
• An infant’s fontanels may be sunken.
• The urine may be dark in colour and low in amount as the body tries to conserve water.
• A client’s blood pressure is affected because the vascular compartment is the first to be affected by dehydration.
• A client’s heartrate will begin to rise in an attempt to maintain blood pressure.
• Initially, however, the loss of water may raise blood pressure as a result of the blood-cell content being more concentrated, in effect ‘thickening’ the blood and therefore needing a higher pressure to get this thicker blood through the vascular system. This can cause headaches.
• Eventually, however, if the client continues to lose fluid, the blood pressure will fall and if the losses are not replaced the client will develop hypovoleamic shock.
• Chronic dehydration (often due to people not wanting to or being unable to drink or take adequate fluids, if for example worried about urinary incontinence) can lead to renal problems and constipation.
• Conditions that can cause dehydration need to be identified and considered. Everyday causes of dehydration include:

1 not drinking enough
2 alcohol
3 smoking
4 caffeine
5 sunstroke
6 central heating
7 infection and pyrexia
8 diarrhoea and vomiting
9 illness (e.g. diabetes mellitus).

In adults, drinking several pints of water can alleviate dehydration quickly. However, when the cause of the dehydration is infection or illness, further treatment, such as intravenous fluids, may be needed. Fluid replacement in infants and children must be undertaken with great care and be calculated exceptionally accurately given the much smaller volumes of fluid involved.