Etiology:

• Physiological causes, eg increased fluid needs d/t climate/temperature change; increased exercise or conditions leading to increased fluid losses; fever causing increased insensible losses, decreased thirst sensation, use of drugs that reduce thirst
• Lack of access to fluid, eg economic constraints, cultural or religious practices, unable to access fluid independently such as elderly or children
• Food and nutrition related knowledge deficit
• Psychological causes, eg depression or disordered eating; dementia resulting in decreased recognition of thirst

S/S:

• Plasma or serum osmolality greater than 290 mOsm/kg
• Increased BUN, increased Na
• Acute weight loss
• Dry skin and mucous membranes, poor skin turgor
• Urine output <30 ml/hr
• Reports or observations of:
• Insufficient intake of fluid compared to requirements
• Thirst
• Difficulty swallowing
• Conditions associated with a diagnosis or treatment of; eg Alzheimer’s disease or other dementia resulting in decreased recognition of thirst; diarrhea
• Use of drugs that reduce thirst