To assess the hydration of the patient you should examine for
- Dryness of oral mucosa and tongue.
- Sunken eyes.
- Skin turgor - pinch the patients skin, on releasing normal skin returns within 2 seconds exception to this is old age and infancy
- Postural fall of BP > 10 mmHg/postural dizziness
- Oliguria
- Invisible jugular venous column in lying posture
Extracellular fluid (ECF ) loss produce the following clinical features
- Dryness of oral mucosa and tongue
- Sunken eyes
- Reduced skin turgor
- Postural fall of BP > 10 mm Hg/postural dizziness
- OliguriaTachycardia
- Prerenal azotemia
- Increased PCV
- Altered sensorium
- Encephalopathy
- Seizure
- Features of shock
- Face is drawn.
- Shrunken eyes.
- Pinched up nose.
- Parched lips.
- Hollowness of temporal fossa.
- Depressed anterior fonlanelle in infants.
- Tongue is dry and coated,
- Skin is dry and wrinkled : subcutaneous tissue feels lax.
- The sign of ridge- If the skin is pinched up by index finger and thumb, and then released,instead of it springing back with normal elasticity, a ridge is formed which subsides slowly this is seen in severe dehydration
- The eyeballs are soft due to lowering of intraocular tension.
- There is hypotension with weak pulse.
- Urine is scanty, dark, concentrated with specific gravity.
