1.Monitor orthostatic blood pressure changes.
Rational : Hypovolemia may be manifested by hypotension and tachycardia.
2.Assess peripheral pulses, capillary refill, skin turgor, and mucous membrane.
Rational : Indicators of level of dehydration, adequacy of circulating volume.
3.Monitor respiratory pattern like Kussmaul’s respirations and acetone breath.
Rational : Lungs remove carbonic acid through respirations, producing a compensatory respiratory alkalosis for ketoacidosis.
4. Monitor input and output. Note urine specific gravity.
Rational : Provides ongoing estimate of volume replacement needs, kidney function, and effectiveness of therapy.
5. Promote comfortable environment. Cover patient with light sheets.
Rational : Avoids overheating, which could promote further fluid loss.
6. Monitor temperature, skin color and moisture.
Rational : Fever, chills, and diaphoresis are common with infectious process; fever with flushed, dry skin may reflect dehydration.
