Which set of signs indicates dehydration is worsening in infants?

• A. Fever, lethargy, irritability, tachycardia
• B. Sunken eyes, sunken fontanelle, loss of skin turgor, dry mucous membranes
• C. Swollen eyes, moist skin, increased appetite, alertness
• D. Jaundice, pale stools, vomiting

Answer: (B)

Worsening dehydration in infants is best recognized by signs that reflect significant fluid loss from body tissues and spaces. A sunken fontanelle is a particularly telling sign, and when it’s present along with sunken eyes, poor skin turgor, and dry mucous membranes, it strongly indicates that dehydration is advancing. As fluids become more depleted, the skin loses elasticity and returns slowly when pinched, the mucous membranes become dry, and the fontanelle may appear notably sunken, with tachycardia or lethargy possible as the body compensates.

This set of signs—sunken eyes, sunken fontanelle, loss of skin turgor, and dry mucous membranes—aligns exactly with dehydration worsening. Signs like fever with irritability can accompany illness but aren’t specific to progression of dehydration; signs of good hydration (moist skin, normal appetite) point away from dehydration, and jaundice or vomiting suggests other issues rather than dehydration progression.