Dehydration

Objectives

1. When assessing the acutely ill patient, look for signs and symptoms of dehydration. (e.g., look for dehydration in the patient with a debilitating pneumonia).
2. In the dehydrated patient, assess the degree of dehydration using reliable indicators (e.g., vital signs) as some patients’ hydration status may be more difficult to assess (e.g., elderly, very young, pregnant).
3. In a dehydrated patient,
   • Determine the appropriate volume of fluid for replacement of deficiency and ongoing needs,
   • Use the appropriate route (oral if the patient is able; IV when necessary).
4. When treating severe dehydration, use objective measures (e.g., lab values) to direct ongoing management.
5. In a dehydrated patient,
   • Identify the precipitating illness or cause, especially looking for non-gastro-intestinal, including drug-related, causes,
   • Treat the precipitating illness concurrently.
6. Treat the dehydrated pregnant patient aggressively, as there are additional risks of dehydration in pregnancy.