Symptom: Thirst, Increased

Initial Grading Reminder


Assessment and Grading

Characterize the symptom (onset, pace)

Ask the patient:

Have you had issues with increased thirst in the past? Do you have diabetes? Is this a new or worsening symptom? When did it start or get worse? Has it developed gradually or suddenly?

Further evaluate the symptom

Ask the patient:

How thirsty are you? Does drinking satisfy the thirst?  Are you waking up at night to drink? Does your mouth feel dry? How much fluid did you have in the last 24-48 hours? Have you had any diarrhea?

Grade the symptom


Patient Query Regarding Other Symptoms/Red Flags

Ask the patient:

Are you urinating frequently? Do you have nausea and/or vomiting; abdominal (belly) pain; weakness; shortness of breath? Are you feeling confused/foggy, or dizzy? Have you had any seizures or uncontrolled shaking?

For patients with diabetes:

Ask what their blood sugar level is and whether they have checked urine ketones.

Patient Factors to Consider That Affect the Approach to Intervention

Consider the following in individualizing the intervention: Is the patient a good or poor historian? Any language barriers or cognitive deficits? Is the patient reliable (able to carry out treatment recommendations)? Does this patient have alcohol/substance abuse issues? Does the patient have transportation? Is there sufficient caregiver support?

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    Suggested Intervention

    If the patient’s profile is consistent with new-onset diabetes, they should be seen. If any of the red-flag symptoms suggesting diabetic ketoacidosis are present, the patient should be seen immediately.

    Patients with known diabetes who have any of these symptoms and/or high blood glucose and urine ketone levels should be seen. Patients should be instructed to go to the ED if blood glucose is >300 mg/dL or if there are multiple symptoms.

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    Differential Diagnosis

    What do you suspect is the cause of the increased thirst?