A nurse is assessing four clients for fluid balance. The nurse should identify that which of the following manifestations of dehydration?

A client who has a urine specific gravity of 1.010. (Reference Range 1.005-1.030)

A client who has a hematocrit of 42%. (Reference Range 36-46%)

A client who has a temperature of 39 °C.

A client who has a weight loss of 2.2 kg in 24 hr.

Answer and Explanation

The Correct Answer is D

Choice A reason: A client who has a urine specific gravity of 1.010 is not dehydrated. Urine specific gravity is a measure of the concentration of solutes in the urine. A normal range is 1.005-1.030, which means that the urine is neither too dilute nor too concentrated. A high urine specific gravity (>1.030) indicates dehydration, as the urine becomes more concentrated due to fluid loss. A low urine specific gravity (<1.005) indicates overhydration, as the urine becomes more dilute due to fluid excess.

Choice B reason: A client who has a hematocrit of 42% is not dehydrated. Hematocrit is the percentage of red blood cells in the blood. A normal range is 36-46% for women and 40-54% for men. A high hematocrit (>54% for men and >46% for women) indicates dehydration, as the blood becomes more viscous due to fluid loss. A low hematocrit (<40% for men and <36% for women) indicates overhydration, as the blood becomes more diluted due to fluid excess.

Choice C reason: A client who has a temperature of 39 °C may or may not be dehydrated. Temperature is a measure of the body's heat production and regulation. A normal range is 36.5-37.5 °C. A high temperature (>37.5 °C) indicates fever, which can be caused by various factors, such as infection, inflammation, or medication. Fever can also cause dehydration, as the body loses fluid through sweating and increased respiration. However, fever is not a specific sign of dehydration, as there may be other causes or contributing factors.

Choice D reason: A client who has a weight loss of 2.2 kg in 24 hr is dehydrated. Weight loss is a measure of the change in the body's mass over time. A normal range is 0.5-1 kg per week. A rapid weight loss (>1 kg per day) indicates dehydration, as the body loses fluid through various routes, such as urine, stool, sweat, or vomit. Weight loss is a sensitive and reliable sign of dehydration, as it reflects the amount of fluid loss.

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Correct Answer is C

Explanation

Choice A reason: Decreased heart rate is not a manifestation of hypovolemia. Hypovolemia is a condition where there is a decreased volume of blood in the body, which can result from blood loss, dehydration, or fluid shifts. Hypovolemia can cause the heart rate to increase, not decrease, as the body tries to compensate for the low blood pressure and maintain adequate perfusion.

Choice B reason: Increased blood pressure is not a manifestation of hypovolemia. Hypovolemia can cause the blood pressure to decrease, not increase, as the blood volume and cardiac output are reduced. The body may try to constrict the blood vessels to increase the blood pressure, but this is usually not enough to overcome the effects of hypovolemia.

Choice C reason: Weak pulse is a manifestation of hypovolemia. Hypovolemia can cause the pulse to become weak, thready, or difficult to palpate, as the blood flow and pressure are diminished. The pulse may also become irregular or rapid, as the heart tries to pump faster and harder to deliver oxygen to the tissues.

Choice D reason: Dyspnea is not a specific manifestation of hypovolemia. Dyspnea is a term for difficulty breathing, which can have many causes, such as asthma, pneumonia, or pulmonary edema. Hypovolemia can cause dyspnea if it leads to shock, which is a life-threatening condition where the organs and tissues are not receiving enough oxygen. However, dyspnea alone is not enough to indicate hypovolemia.

A. Gastritis B. GERD C. Peptic ulcer disease D. Pancreatitis

Correct Answer is B

Explanation

Choice A reason: Gastritis is not the most likely condition that these clinical manifestations indicate. Gastritis is an inflammation of the stomach lining, which can cause abdominal pain, nausea, vomiting, and loss of appetite. Gastritis may cause heartburn or dyspepsia, but it does not usually cause dysphagia, which is difficulty swallowing.

Choice B reason: GERD is the most likely condition that these clinical manifestations indicate. GERD stands for gastroesophageal reflux disease, which is a chronic condition where the stomach acid flows back into the esophagus, causing irritation and inflammation. GERD can cause heartburn, which is a burning sensation in the chest or throat, dysphagia, which is difficulty swallowing or a feeling of a lump in the throat, and dyspepsia, which is indigestion or discomfort in the upper abdomen.

Choice C reason: Peptic ulcer disease is not the most likely condition that these clinical manifestations indicate. Peptic ulcer disease is a condition where there are open sores or ulcers in the lining of the stomach or duodenum, which can cause bleeding, perforation, or obstruction. Peptic ulcer disease can cause dyspepsia, which is indigestion or discomfort in the upper abdomen, but it does not usually cause heartburn or dysphagia, which are more characteristic of GERD.

Choice D reason: Pancreatitis is not the most likely condition that these clinical manifestations indicate. Pancreatitis is an inflammation of the pancreas, which can cause severe abdominal pain, nausea, vomiting, fever, and jaundice. Pancreatitis does not cause heartburn, dysphagia, or dyspepsia, which are more characteristic of GERD.

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