The LPN is working in a long term care facility and caring for all of the following residents. Which patient is most likely to be dehydrated?
A 72-year old who is consuming large amounts of water.
A 78-year old who has lost 1 pound in the last week.
A 71-year old who has diarrhea.
An 85-year old who has decreased skin turgor.
The correct answer and explanation is:
The correct answer is: An 85-year-old who has decreased skin turgor.
Explanation:
Dehydration occurs when the body loses more fluid than it takes in, leading to an imbalance. It can be caused by a variety of factors, such as illness, medications, or inadequate fluid intake. In long-term care facilities, dehydration is a common concern, especially among elderly residents due to changes in the body’s ability to conserve water.
One of the classic signs of dehydration is decreased skin turgor, which is the skin’s reduced elasticity. When skin is pinched, it should return to its normal position quickly. In dehydrated individuals, the skin often stays “tented” or does not return to normal, indicating fluid loss. This finding is most commonly seen in elderly individuals because skin elasticity naturally decreases with age, but it is exacerbated by dehydration.
The other residents mentioned in the options are less likely to be dehydrated:
- The 72-year-old consuming large amounts of water is likely to be adequately hydrated. While it is essential to monitor how much water they are consuming to ensure it is balanced, drinking large amounts of water typically prevents dehydration.
- The 78-year-old who has lost 1 pound in the last week may not necessarily be dehydrated. A weight loss of 1 pound over a week is generally not significant enough to indicate dehydration. Weight loss can be attributed to many other factors like dietary changes or mild fluid shifts.
- The 71-year-old with diarrhea is at risk for dehydration but this alone does not confirm dehydration. Diarrhea can cause fluid loss, and it is important to monitor for signs like increased thirst, dry mouth, and decreased urine output.
In summary, decreased skin turgor in the 85-year-old is the most direct and reliable indicator of dehydration in this scenario. It is essential for the LPN to closely monitor this resident’s fluid balance and ensure they are receiving adequate hydration.