In an older adult with dehydration, which finding would the nurse identify as an early sign?

• A. Change in mental status
• B. Dry mucous membranes
• C. Decreased skin turgor
• D. Sunken eyes

Answer: (A)

In older adults, mental status changes are an early signal of dehydration because the brain is particularly sensitive to reduced circulating volume and electrolyte shifts, and thirst perception often diminishes with age. Confusion, agitation, or lethargy can appear before the visible physical signs of dehydration, making cognitive changes an important early clue. The other signs—dry mucous membranes, decreased skin turgor, and sunken eyes—tend to reflect more established fluid loss and can be unreliable in the elderly due to aging changes and chronic conditions, so they are less useful as early indicators. Recognizing any new confusion or altered cognition should prompt a prompt assessment of hydration and fluid intake.