6.3.2 Dehydration

Dehydration occurs when you use or lose more fluid than you take in, and your body doesn’t have enough water and other fluids to carry out its normal functions. If you don’t replace lost fluids, you will get dehydrated.

Two senior women are chatting while drinking tea.
Hydration should occur throughout the day, not just at meal times.

Illnesses involving emesis (vomiting), diarrhea, and excessive urination without completely replacing the fluids lost from this condition will easily lead to dehydration in young children and elders if not monitored.  This is the reason recording what fluids are taken in and what fluids come out of the body is extremely important when assisting those who are ill. Anyone may become dehydrated, but the condition is especially dangerous for young children and older adults. Below are listed the signs and symptoms to look for if you suspect dehydration.

Person Symptoms Treatment
In young children: 
  • a dry mouth and tongue
  • lack of tearing if crying
  • three hours without a wet diaper or voiding
  • eyes lack moisture and become sunken
The child needs medical care immediately.
In elderly persons:
  • extreme thirst
  • reduced need to urinate
  • urine becomes darker
  • client becomes tired and weak
  • dizzy and confused
Medical attention is needed and a full assessment to determine why the client is dehydrated if no current illness of question is known. If they have diarrhea for 24 hours, are more tired or sleepy than usual, cannot drink or keep fluids in their stomach or are noticed to have black tarry stool, the doctor needs to be advised and medical attention is needed.
Table: Symptoms and Treatment for Dehydration

Record-keeping is important in these circumstances.  An intake and output record (I&O record) will be used to determine how much fluid to replace.  Depending on the illnesses or disease process the client is diagnosed with, the fluids will need to be vigorously controlled. The following example of an I&O record shows the detail needed. Notice the intake is matched against the output to maintain a balance.

In the figure below, you will see on the left side the time of the intake. The next section states this intake was intravenous (in the vein), but it could also be used for oral (in the mouth) or in a feeding tube, or by bottle (infant).  The next column is for the amount of intake, this will be in ML (millilitres) or in ounces. The last columns are to measure the fluids that come out of the body.  The amount that goes in needs to balance with the amount going out. Click on the image for a larger version.

Intake-output chart


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