A nurse is reviewing the laboratory findings of a client who has Clostridium difficile. Which of the following findings should indicate to the nurse that the client is experiencing a fluid volume deficit?
Clear-colored urine
Decreased urine specific gravity
Increased hematocrit
Hypertension
The Correct Answer is C
A. Clear-colored urine: Clear-colored urine typically indicates adequate hydration or even overhydration. In Clostridium difficile, where the client may be experiencing profuse diarrhea, clear urine would not align with fluid volume deficit. This finding suggests the kidneys are excreting diluted urine, which is not consistent with dehydration.
B. Decreased urine specific gravity: A decreased urine specific gravity reflects dilute urine and usually points to overhydration or an inability to concentrate urine. In a client with C. difficile and likely diarrhea-related fluid loss, the expected finding would be a concentrated urine with increased specific gravity, not decreased.
C. Increased hematocrit: An increased hematocrit indicates hemoconcentration, which occurs when plasma volume is reduced due to fluid loss. In the setting of Clostridium difficile infection, where fluid is lost rapidly through diarrhea, this rise in hematocrit is a classic marker of fluid volume deficit. It reflects the relative increase in red blood cells due to a lower plasma volume.
D. Hypertension: Hypertension is more commonly associated with fluid volume excess or other cardiovascular conditions. In cases of fluid volume deficit, hypotension or orthostatic hypotension is more expected due to decreased circulating blood volume. Therefore, high blood pressure would not support the diagnosis of dehydration in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Offer the client a selection of beverages at each meal: Providing a variety of beverages may offer hydration and a sense of control, but clients with anorexia nervosa often use fluids to avoid calorie-dense solid foods. This approach can reinforce avoidance behaviors and does not contribute meaningfully to nutritional rehabilitation or psychological recovery.
B. Inform the client that a weight gain of 2.3 kg (5 lb) per week is expected: A weight gain goal of 2.3 kg per week is too aggressive and may provoke anxiety or resistance from the client. A slower, more gradual goal of 0.5 to 1 kg (1 to 2 lb) per week is considered safer and more psychologically tolerable. Unrealistic expectations can harm rapport and may lead to nonadherence or relapse.
C. Arrange for someone to remain with the client for 30 min after meals: Monitoring after meals is essential to prevent purging or other compensatory behaviors. The standard is 60 to 90 minutes post-meal observation to address delayed attempts at purging or exercising. Thus, while well-intentioned, this time frame is insufficient.
D. Encourage the client to participate in developing dietary goals: Involving the client in setting dietary goals promotes a sense of autonomy, collaboration, and ownership in the recovery process. This approach is therapeutic, reduces power struggles, and helps build trust between the nurse and the client.
Correct Answer is ["1400"]
Explanation
Convert weight to kilograms.
Weight (kg) = 154 lb / 2.2 lb/kg
= 70 kg
Calculate current daily calories.
Current calories = 30 cal/kg/day × 70 kg
= 2100 cal
Calculate the calorie decrease.
Decrease = 10 cal/kg/day × 70 kg
= 700 cal
Calculate the new daily calorie intake.
New intake = 2100 cal - 700 cal
= 1400 cal
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