Ila Swan: patient advocate


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Signs of Dehydration

I will first give you what I have seen happen, then I will give you the clinical version of it:

When a person's fluid level drops, either due to:

  1. inadequate fluid intake,
  2. Vomiting
  3. sweating or
  4. diarrhea,
the first indications of not enough fluid in the system would be:
a) darkened yellow-amber colored urine,
b) strong smelling or foul smelling urine,
c) the appearance of the skin loses its normal appearance, scaly skin. The thing I look for in the skin, is extended normal veins under the skin. A person who is not dehydrated has veins that pop right back in place when you press gently on them. If you look at the back of your hand, you can see where the blood vessels sort of sit up above the basic skin. When a person is dehydrated, GENTLY using your thumb and pointer finger, pinch the skin together on the back of the hand to form a peak. In a person who is suffering dehydration, the peak will stay up in the peak position about twice as long as the skin of a person who is not dehydrated. The reason for this is the volume of blood in the blood vessels and volume of fluid in the tissues under the skin is insufficient to stretch the skin back to it's normal place.
d) urinary tract infection, e) poor posture: the patient's posture changes from sitting upright to drooping at the shoulders, leaning to one side or the other, basically slumped over.
f) "cotton mouth.' White sputum in the corners of their mouth and a white marbled tongue, the spit seems too stringy.
g) confusion,
h) feeling faint or even fainting and falling down,
i) gasping for air (air hunger): most often in severe cases of dehydration, the blood becomes thickened and does not carry enough oxygen through the vessels to oxygenate the person. So you will see the person gasping for air. It's a horrible site and death can take hours, while you watch the person struggling to get air.

Now I will give you the clinical version: The principal physical signs are decreased skin turgor, a shrunken and corrugated tongue, postural hypotension, severe cases there is shock, lethargy, weakness, confusion and oliguria (little urine). Plasma protein concentration and hematocrit are increased or decreased, depending on the proportions of sodium and water loss. Renal function is always compromised.

I hope this will help you,

Ila Swan

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