The nurse is providing instruction to an older female client who is prescribed furosemide and has episodes of incontinence. Which of the following should the nurse include in the teaching about hydration?

"Consult your primary health care provider if any illness with diarrhea or vomiting lasts longer than 24 hours."
"Continue to drink the normal recommended daily intake of fluid when taking diuretics."
"Replace fluids lost from illness or sweating with clear liquids."


• The Institute of Medicine recommends that adults have a daily fluid intake of 2.2 L (for women) or 3 L (for men) per day.

• Illnesses with diarrhea or vomiting lasting longer than 24 hours can severely affect fluid balance. Seeking medical advice can help provide immediate and prompt interventions related to fluid and electrolyte replacement.

• Clients taking diuretics should be encouraged to drink normally to avoid rebound fluid retention syndrome, where plasma volume drops too low, triggering the renin cascade.

• Reducing fluid intake as a way of decreasing urinary incontinence in older adults is inappropriate. Bladder irritability can increase with limited fluid intake, leading to uninhibited contractions and altering the neurologic stimulus that controls normal bladder emptying.

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