A client is taking a diuretic that increases her urinary output.
What would be an appropriate nursing diagnosis on which to base an educational plan?

Impaired Skin Integrity.

Impaired Urinary Elimination.

Urinary Retention.

Risk for Deficient Fluid Volume.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Impaired Skin Integrity involves damage to the epidermal and/or dermal layers of the skin. While excessive fluid loss can indirectly affect skin turgor and increase the risk of breakdown over time, the primary and immediate physiological consequence of increased urinary output due to a diuretic is a potential reduction in overall fluid volume within the body, not a direct impairment of skin integrity.

Choice B rationale

Impaired Urinary Elimination describes difficulties in controlling or completely emptying the bladder. A diuretic, by its mechanism of action, increases urine production and thus promotes urinary elimination. While the *pattern* of elimination may change (increased frequency, urgency), the fundamental issue is not an impairment of the elimination process itself but rather an *increase* in it.

Choice C rationale

Urinary Retention is the inability to empty the bladder completely. A diuretic works to increase urine output, directly counteracting the physiological process of urinary retention. Therefore, this nursing diagnosis would be inappropriate for a client experiencing increased urinary output due to diuretic use.

Choice D rationale

Risk for Deficient Fluid Volume is a nursing diagnosis that identifies a vulnerability to a decrease in intravascular, interstitial, and/or intracellular fluid, which may compromise health. A diuretic increases urinary output, leading to a greater loss of fluid from the body. Without adequate fluid intake to compensate for this increased loss, the client is at a significant risk of developing a fluid volume deficit.

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Correct Answer is D

Explanation

Choice A rationale

Relying solely on written communication can be time-consuming and may not be suitable for all situations or for clients with low literacy. While it can be a useful adjunct, it shouldn't replace verbal communication entirely.

Choice B rationale

Reducing time spent with the client can hinder effective communication and relationship building. It doesn't address the communication barrier and may leave the client feeling unheard and uncared for.

Choice C rationale

Speaking loudly can distort sounds and make it harder for someone with a hearing deficit to understand. It can also be perceived as disrespectful or condescending. The approach should focus on clarity, not volume.

Choice D rationale

Background noise, such as a television, can significantly interfere with a hearing-impaired person's ability to understand speech. Reducing or eliminating such distractions creates a clearer auditory environment, facilitating better comprehension of verbal communication.

A. The amount of stage 4 sleep increases as clients age. B. Circadian rhythms become more prominent as clients age. C. Older clients fall asleep more quickly than younger ones. D. Total sleep time decreases as clients age.

Correct Answer is D

Explanation

Choice A rationale

The amount of stage 4 (deep, slow-wave) sleep actually decreases as individuals age. Older adults tend to have less deep sleep and more fragmented sleep patterns with increased awakenings.

Choice B rationale

Circadian rhythms, the body's internal clock regulating sleep-wake cycles, tend to become less prominent or more easily disrupted as clients age. This can lead to changes in sleep timing, such as earlier bedtimes and wake times.

Choice C rationale

Older clients typically take longer to fall asleep (increased sleep latency) compared to younger individuals due to various physiological and environmental factors.

Choice D rationale

Total sleep time generally decreases with age. Older adults often require and obtain less sleep per night compared to younger adults. This is a normal physiological change associated with aging.

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A client is taking a diuretic that increases her urinary output.What would be an appropriate nursing diagnosis on which to base an educational plan?

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A client is taking a diuretic that increases her urinary output.
What would be an appropriate nursing diagnosis on which to base an educational plan?