Gero: Toward Healthy Aging Chapter 15
Hydration and Oral Care
Hydration Management - ANSimportant for thermoregulation and dilution of water-soluble
medications, facilitates bowel and renal function, and maintains metabolic processes
A significant number of older adults drink less than 1 liter of fluid/day, less than the
recommended amount of 1500 mL/day
Age-related changes affecting hydration - ANSThirst sensation diminishes
Decrease in kidneys ability to concentrate urine
Total body water decreases
Loss of muscle mass and increase in fat cells
Issues associated with Dehydration - ANSthromboembolic complications, kidney stones,
constipation, falls, medication toxicity, renal failure, seizure, electrolyte imbalance, hyperthermia,
and delayed wound healing
Risk factors for dehydration include - ANSemotional illness, surgery, trauma, higher
physiological demands
Signs and symptoms of Dehydration - ANSoften atypical in the older adult
Skin turgor is not a reliable indicator in older adults
Look for dry mucous membranes in mouth and nose, furrows on the tongue, orthostasis, speech
incoherence, rapid pulse, decreased urine output, extremity weakness, dry axilla, and sunken
eyes.
Laboratory tests and urine - ANSserum sodium, serum and urine osmolarity, and specific gravity
Interventions - ANS-Based on comprehensive assessment, risk identification, and hydration
management
-Monitor closely and implementation of intake and output is essential
-Oral hydration is the first treatment approach
-Water is the best fluid to offer
Rehydration - ANSintravenous
-Replace 50% of loss within first 12 hours or sufficient quantity to relieve tachycardia and
hypotension
Hypodermoclysis
-Infusion of isotonic fluids into the subcutaneous space
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