K.B. is a 32-year-old woman being admitted to the medical floor for complaints of fatigue and dehydration. While taking her history, you discover that she has diabetes mellitus (dM) and has been insulin
dependent since the age of 8 .
She has undergone hemodialysis (Hd) for the past 2 years because of endstage renal disease (ESRd). Your initial assessment of K.B. reveals a pale, thin, slightly drowsy woman. Her
skin is warm and dry to the touch with poor skin turgor, and her mucous membranes are dry. Her vital
signs are 140/88, 116, 18, 99.9 ° F (37.7 ° C). She tells you she has been nauseated for 2 days so she has
not been eating or drinking. She reports severe diarrhea. The following blood chemistry results are back.
What aspects of your assessment support her admitting diagnosis of dehydration?
• The patient's history supports an admitting diagnosis of dehydration because she told you she has
not been drinking for 2 days and reports severe diarrhea. Her skin is warm and dry with poor skin
turgor and dry mucous membranes, all of which can be physical assessment findings of a patient
with dehydration.
• Fluid is restricted when the person is on dialysis.
• Although most of her laboratory findings are elevated, laboratory values are not a good indicator
of dehydration in patients on HD.
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