ch 15 - hydration and oral care Flashcards
recommended amount water intake per day older adult
1500 mL
why is water important in the body (4)
- thermoregulation
- dilution of water soluble meds
- facilitates bowel and renal functions
- maintins metabolic processes
age related changes affecting hydration (7)
- thirst sensation diminishes
- creatinine clearance declines
- total body water decreases
- loss of muscle mass and increase in fat cells
- meds
- functional impairment
- comorbidities (ex: diabetes, resp illness, HF)
2 types dehydration
- water loss
- volume depletion
significant issues related to dehydration (10)
- thromboembolisms
- kidney stones
- constipation
- falls
- med toxicity
- renal failure
- seizure
- electrolyte imbalance
- hyperthermia
- delayed wound healing
risk factors for dehydration (8)
- emotional illness
- surgery
- trauma
- higher physiological demands
- meds
- functional deficits
- oral problems
- high environmental temps
S+S dehydration in older adults (9)
- dry mucous membranes nose and mouth
- furrows on tongue
- orthostatic hypoTN
- speech incoherence
- rapid pulse
- decreased urine output
- extremity weakness
- dry axilla
- sunken eyes
what labs communicate dehydration (4)
- hyponatremia
- serum osmolarity (>300)
- increased BUN
- changes in urine (amount, color, osmolality, specific gravity)
2 options for rehydration other than oral intake
- IV
- hypodermoclysis (isotonic fluids in subq space)
tips for rehydrating with IV fluids
- replace 50% of loss within 12 hours (or enough to relieve tachycardia and hypoTN)
- then rehydrate slowly
- monitor for fluid overload
tips for rehydrating through hypodermoclysis
- isotonic fluids into subq space
- not indicated for severe dehydration (more than 3 L over 24 hours)
tips for oral rehydration (7)
- calculate fluid goal (atleast 1500 mL/day)
- provide fluids consistently throughout day (75-80% at mealtimes)
- make fluids accessible at all times
- fluid rounds
- possibly modify container/cup
- allow adequate time for feeding
- monitor I&Os
what can lead to water-loss dehydration? what manifestations are seen?
CAUSE:
-insufficient fluid intake
MANIFESTATIONS:
- increased serum osmolality
- decreased ECF
what can lead to volume-depletion dehydration? what manifestations are seen?
CAUSE:
- V/D
- excessive bleeding/loss of plasma
MANIFESTATIONS:
- rapid dehydration
- electrolyte imbalance
S+S fluid volume overload (4)
- unexplained weight gain
- pedal medema
- JVD
- SOB
