Which combination of signs most strongly suggests dehydration in a toddler?

• A. Dry mucous membranes, decreased tears, sunken fontanelle, and reduced urine output.
• B. Prolonged capillary refill time only.
• C. Increased appetite and weight gain.
• D. Normal mucous membranes with clear urine.

Answer: (A)

When assessing dehydration in a toddler, look for several signs of reduced body fluids and perfusion. Dry mucous membranes show a lack of moisture from fluid loss, and decreased tears reflect reduced lacrimal fluid due to dehydration. A sunken fontanelle indicates loss of volume affecting the growing skull bones, and reduced urine output shows the kidneys conserving water as the body tries to maintain circulation. Put together, these signs signal significant dehydration more strongly than any single feature.

In contrast, a single sign like prolonged capillary refill time can occur with dehydration but isn’t as definitive on its own. Increased appetite and weight gain don’t fit dehydration, and normal mucous membranes with clear urine suggest adequate hydration.