A 76-year-old male with vomiting and diarrhea has pale, dry conjunctivae and cannot keep down fluids for two days. What is the most appropriate action?

• A. Moisten his conjunctivae
• B. Place him in the Trendelenburg position
• C. Have him take small sips of water
• D. Administer oxygen

Answer: (D)

Dehydration from vomiting and diarrhea can reduce circulating volume, leading to decreased tissue perfusion and oxygen delivery. The pale, dry conjunctivae indicate volume depletion, and since he cannot take fluids by mouth, oral rehydration isn’t feasible right now. The immediate priority is to support oxygenation and perfusion while arranging for rapid transport and fluids. Administering oxygen helps ensure tissues receive adequate oxygen even if circulating volume is low, and it can help prevent progression to shock. The other options don’t address the underlying issue: moistening conjunctivae is not a treatment, Trendelenburg position is not helpful and can worsen breathing, and small sips of water risk aspiration and won’t reverse dehydration in this case.