Which combination of findings would support dehydration as a cause of dizziness and warrant referral?

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The key idea is recognizing dehydration as a plausible cause of dizziness when there are signs of reduced hydration, evidence of volume-related blood pressure change, and a recent pattern of low fluid intake. Dehydration lowers intravascular volume, which can produce dizziness, especially upon standing, due to orthostatic changes. Decreased skin turgor is a classic bedside clue that the body is dry, reflecting overall fluid deficit. A recent history of low fluid intake directly supports that the body’s circulating volume is reduced. When these three pieces come together—low skin turgor, orthostatic changes on vitals, and a recent drop in fluid intake—they most convincingly point to dehydration as the cause of dizziness and indicate a need for medical referral to prevent progression to more serious volume depletion or complications.

If skin turgor were normal and there were no orthostatic changes, dehydration would be less likely. Hypertension with orthostatic changes doesn’t fit the typical dehydration pattern, and while dehydration signs with no stated fluid intake history could occur, the combination of all three findings provides the strongest, most specific justification for referral.