What clinical signs and symptoms should I assess to determine dehydration in adults?

To determine dehydration in adults, assess the following clinical signs and symptoms: altered mental status such as irritability, lethargy, or decreased level of consciousness; reduced urine output; dry mucous membranes (except in mouth breathers); sunken eyes; skin turgor (reduced skin elasticity); tachycardia; prolonged capillary refill time; weak peripheral pulses; pale or mottled skin; cold extremities; and hypotension in severe cases indicating shock ¹.

Additionally, adults may present with nonspecific symptoms such as thirst, dizziness, and muscle cramps. In older adults, clinical signs can be subtle; therefore, careful assessment of mental status changes and skin turgor is particularly important (Hooper et al., 2015). Laboratory tests are not routinely required but may be indicated if intravenous fluids are needed or hypernatraemia is suspected ¹.

Overall, a combination of these clinical features should be evaluated to identify dehydration severity, with particular attention to red flag signs such as altered responsiveness, tachycardia, hypotension, and prolonged capillary refill time, which suggest more severe dehydration or hypovolaemic shock ¹.