A nurse is reviewing the laboratory results of a client who has dehydration. Which of the following findings indicates an increase in osmolality?
Serum sodium 140 mEq/L.
Serum potassium 4.0 mEq/L.
Serum glucose 90 mg/dL.
Serum urea nitrogen 25 mg/dL.
The Correct Answer is D
Choice A reason: Serum sodium 140 mEq/L is a normal value and does not indicate an increase in osmolality. Osmolality is the concentration of dissolved particles in a fluid. Sodium is one of the main electrolytes that affect osmolality, but a normal sodium level does not necessarily mean a normal osmolality.
Choice B reason:
Serum potassium 4.0 mEq/L is also a normal value and does not indicate an increase in osmolality. Potassium is another electrolyte that affects osmolality, but it has a smaller effect than sodium. A normal potassium level does not necessarily mean a normal osmolality.
Choice C reason:
Serum glucose 90 mg/dL is also a normal value and does not indicate an increase in osmolality. Glucose is another substance that affects osmolality, but it has a smaller effect than electrolytes. A normal glucose level does not necessarily mean a normal osmolality.
Choice D reason:
Serum urea nitrogen 25 mg/dL is an elevated value and indicates an increase in osmolality. Urea nitrogen is a waste product of protein metabolism that is excreted by the kidneys. Urea nitrogen is one of the main substances that affect osmolality, along with sodium and glucose. An elevated urea nitrogen level means that the blood is more concentrated and has less water. This can be caused by dehydration, which is a common condition in clients who have dehydration. Dehydration leads to an increase in serum osmolality and activation of antidiuretic hormone (ADH), which results in urinary concentration. Therefore, choice D is the correct answer.
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Correct Answer is D
Explanation
Choice A reason: Serum sodium 140 mEq/L is a normal value and does not indicate an increase in osmolality. Osmolality is the concentration of dissolved particles in a fluid. Sodium is one of the main electrolytes that affect osmolality, but a normal sodium level does not necessarily mean a normal osmolality.
Choice B reason:
Serum potassium 4.0 mEq/L is also a normal value and does not indicate an increase in osmolality. Potassium is another electrolyte that affects osmolality, but it has a smaller effect than sodium. A normal potassium level does not necessarily mean a normal osmolality.
Choice C reason:
Serum glucose 90 mg/dL is also a normal value and does not indicate an increase in osmolality. Glucose is another substance that affects osmolality, but it has a smaller effect than electrolytes. A normal glucose level does not necessarily mean a normal osmolality.
Choice D reason:
Serum urea nitrogen 25 mg/dL is an elevated value and indicates an increase in osmolality. Urea nitrogen is a waste product of protein metabolism that is excreted by the kidneys. Urea nitrogen is one of the main substances that affect osmolality, along with sodium and glucose. An elevated urea nitrogen level means that the blood is more concentrated and has less water. This can be caused by dehydration, which is a common condition in clients who have dehydration. Dehydration leads to an increase in serum osmolality and activation of antidiuretic hormone (ADH), which results in urinary concentration. Therefore, choice D is the correct answer.
Correct Answer is C
Explanation
Choice A reason:
Increased hematocrit is not a finding of fluid overload, but rather of dehydration. Hematocrit is the percentage of red blood cells in the blood volume. When the blood volume decreases due to fluid loss, the hematocrit increases.
Choice B reason:
Decreased heart rate is not a finding of fluid overload, but rather of fluid deficit. When the blood volume increases due to fluid retention, the heart rate increases to maintain cardiac output.
Choice C reason:
Crackles in the lungs are a finding of fluid overload. Crackles are caused by fluid accumulation in the alveoli, which interferes with gas exchange and produces a crackling sound on auscultation.
Choice D reason:
Sunken eyeballs are not a finding of fluid overload, but rather of dehydration. Sunken eyeballs are caused by loss of subcutaneous fat and tissue turgor due to fluid loss. Some additional sentences are.
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