Which symptom is critical when evaluating a child’s risk for dehydration?

Decreased skin turgor is a critical symptom when evaluating a child’s risk for dehydration. Skin turgor refers to the skin's elasticity and its ability to return to its normal position after being pinched. In a well-hydrated child, the skin quickly returns to its original position; however, in a dehydrated child, the skin tends to remain tented when pinched, indicating reduced fluid levels in the body. This physical examination finding is a key indicator of the body’s hydration status.

While increased thirst is a common response to dehydration, it is a subjective symptom and not necessarily measurable, making it less reliable than objective signs like skin turgor. Normal urination suggests that the child is adequately hydrated, which contradicts the assessment of dehydration risk. Consistent energy levels can vary for many reasons and may not specifically indicate hydration status; children can still maintain energy levels despite being dehydrated until it reaches a more severe stage. Thus, decreased skin turgor stands out as a definitive and measurable sign in assessing dehydration risk in a child.