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Significance of hydration of patient

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
In dehyadration there is loss of ECF volume, ICF volume and IVF volume 
Extracellular fluid (ECF ) loss produce the following clinical features
  • Dryness of oral mucosa and tongue
  • Sunken eyes
  • Reduced  skin turgor
Intravascular fluid (IVF) loss produce the following features
  • Postural fall of BP > 10 mm Hg/postural dizziness
  • OliguriaTachycardia
  • Prerenal azotemia
  • Increased PCV
Intracellular fluid ICF volume loss produce 
  • Altered sensorium
  • Encephalopathy
  • Seizure
  • Features of shock
What are the clinical signs of dehydration?
  • 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.


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