Which symptom might indicate severe dehydration in a patient with DKA?

In patients experiencing diabetic ketoacidosis (DKA), identifying symptoms of severe dehydration is crucial. Warm, dry skin and dry mucous membranes indicate a significant loss of fluids, which can occur in DKA due to the osmotic diuresis caused by high blood glucose levels. This diuresis leads to the excessive loss of water and electrolytes, which, when compounded with the metabolic derangements of DKA, results in notable dehydration.

Warm, dry skin suggests inadequate hydration, while dry mucous membranes are a direct indicator of fluid deficiency in the body. Together, these symptoms reflect the severity of the dehydration, indicating that the patient may require immediate fluid resuscitation and management to restore hydration and address the underlying DKA condition.

The other symptoms mentioned, such as fruity breath odor and excessive urination, are related to DKA itself rather than directly indicating severe dehydration. Increased appetite does not correlate with dehydration but rather reflects different metabolic changes. Thus, recognizing warm, dry skin and dry mucous membranes as indicators of severe dehydration is essential in the context of DKA management.