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Questions and Answers
A nurse is performing an admission assessment on a client who has hypovolemia due to vomiting and diarrhea. The nurse should expect which of the following findings? (Select all that apply)
A nurse is performing an admission assessment on a client who has hypovolemia due to vomiting and diarrhea. The nurse should expect which of the following findings? (Select all that apply)
- Syncope (correct)
- Distended neck veins
- Decreased skin turgor (correct)
- Tachycardia (correct)
- Hyperthermia (correct)
A nurse should identify that which of the following clients is at risk for hypovolemia?
A nurse should identify that which of the following clients is at risk for hypovolemia?
- A client who has NG suctioning (correct)
- A client who took an overdose of Na+ bicarbonate antacids
- A client who has chronic constipation
- A client who has syndrome of inappropriate ADH
Which of the following findings is a manifestation of dehydration? (Select all that apply)
Which of the following findings is a manifestation of dehydration? (Select all that apply)
- Serum Na+ 150mEq/L (correct)
- Hct 55% (correct)
- Serum creatinine 0.6mg/dL
- Urine specific gravity 1.035 (correct)
- Serum osmolarity 260mOsm/kg
For which of the following clients should the nurse anticipate a prescription for fluid restriction?
For which of the following clients should the nurse anticipate a prescription for fluid restriction?
Which diagnostic procedure is preferred to indicate pulmonary congestion?
Which diagnostic procedure is preferred to indicate pulmonary congestion?
Which of the following actions should the nurse include for a client who has dehydration?
Which of the following actions should the nurse include for a client who has dehydration?
A patient with a medical diagnosis of CHF is admitted with complaints of SOB. The nurse should expect to discover what other findings? (Select all that apply)
A patient with a medical diagnosis of CHF is admitted with complaints of SOB. The nurse should expect to discover what other findings? (Select all that apply)
Which of the following is correct regarding fluid volume excess (FVE)? (Select all that apply)
Which of the following is correct regarding fluid volume excess (FVE)? (Select all that apply)
Which action should the nurse take for an older adult client in a LTC facility who is dehydrated?
Which action should the nurse take for an older adult client in a LTC facility who is dehydrated?
Which of the following findings should a nurse expect in a client who is dehydrated due to fluid volume deficit (FVD)?
Which of the following findings should a nurse expect in a client who is dehydrated due to fluid volume deficit (FVD)?
A nurse is observing an older adult client receiving packed RBCs. Which findings should the nurse identify as manifestations of FVE and report? (Select all that apply)
A nurse is observing an older adult client receiving packed RBCs. Which findings should the nurse identify as manifestations of FVE and report? (Select all that apply)
Which of the following findings should the nurse identify as manifestations of fluid volume deficit (FVD)? (Select all that apply)
Which of the following findings should the nurse identify as manifestations of fluid volume deficit (FVD)? (Select all that apply)
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Study Notes
Fluid Volume Deficit (FVD)
- Hypovolemia due to vomiting and diarrhea may present with manifestations such as tachycardia, syncope, decreased skin turgor, and hyperthermia.
- Clients with NG suctioning are at high risk for hypovolemia due to excessive gastrointestinal losses.
- Indicators of dehydration include elevated hematocrit, increased serum sodium, and high urine specific gravity, reflecting hemoconcentration.
- Assessing daily weight is crucial for patients with dehydration to evaluate treatment efficacy.
Fluid Volume Excess (FVE)
- Clients with heart failure require fluid and sodium restriction to alleviate cardiac workload.
- Symptoms like tachycardia, moderate edema, hypertension, and dizziness may indicate FVE, often seen in congestive heart failure patients.
- Diagnostically, decreased serum and urine osmolarity, lower hematocrit and hemoglobin levels, and increased urinary output align with fluid overload conditions.
Nursing Interventions
- Monitor for signs of orthostatic hypotension in dehydrated older adults due to reduced circulatory volume.
- Anticipate the development of weak, thready pulses in clients experiencing fluid volume deficit resulting from low blood pressure.
- For patients receiving packed RBCs, watch for dyspnea, edema, hypertension, and overall weakness as signs of developing fluid volume excess.
Key Laboratory Findings
- Decreased BUN, urine sodium, and specific gravity typically indicate overhydration or fluid excess conditions.
- Concentrated urine, alongside findings like decreased skin turgor and elevated temperature, suggest fluid volume deficit.
Important Patient Education
- Encourage hydration awareness and monitoring in at-risk populations to prevent complications from both FVD and FVE.
- Advise against excessive fluid intake in conditions like heart failure or renal impairment to avoid fluid overload scenarios.
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