A nurse is reviewing the laboratory results of a client who has fluid volume deficit. The nurse would expect which of the following findings?
Urine specific gravity 1.035.
BUN 19 mg/dL.
Hematocrit 44.9%.
Sodium 155 mEq/L.
The Correct Answer is A
Sodium 155 mEq/L. Choice A rationale:
A urine specific gravity of 1.035 indicates concentrated urine and is consistent with fluid volume deficit. However, it is not the most specific finding for this condition.
Choice B rationale:
A BUN (blood urea nitrogen) level of 19 mg/dL can be a normal value. It is within the reference range (usually around 7-20 mg/dL) and does not provide specific information about fluid volume deficit.
Choice C rationale:
A hematocrit of 44.9% can also be within the normal range for some individuals, and while it can be elevated in cases of fluid volume deficit, it is not as sensitive as other parameters for detecting this condition.
Choice D rationale:
This is the correct answer because a sodium level of 155 mEq/L is elevated and indicates hypernatremia, which is associated with fluid volume deficit. Hypernatremia occurs when there is a relative lack of water in relation to the sodium concentration in the blood, and it can lead to dehydration
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice A: Encourage the patient to breathe in and out slowly into a paper bag.
Choice A rationale:The patient’s arterial blood gas (ABG) results indicate respiratory alkalosis, as evidenced by the elevated pH (7.48) and decreased PaCO2 (25 mm Hg). Respiratory alkalosis often results from hyperventilation, which can occur due to anxiety. Breathing into a paper bag helps to increase CO2 levels in the blood, thereby correcting the alkalosis.
Choice B rationale:Administering oxygen is not appropriate in this scenario because the patient’s PaO2 is already elevated (110 mm Hg), indicating that oxygenation is not the issue. Providing additional oxygen would not address the underlying problem of hyperventilation and respiratory alkalosis.
Choice C rationale:Intravenous sodium bicarbonate is used to treat metabolic acidosis, not respiratory alkalosis. In this case, the patient’s HCO3 is within the normal range (24 mEq/L), indicating that there is no metabolic acidosis present.
Choice D rationale:Starting an intravenous fluid bolus with isotonic fluids is not indicated for correcting respiratory alkalosis. This intervention is more appropriate for patients experiencing hypovolemia or dehydration, which is not suggested by the patient’s ABG results.
Correct Answer is D
Explanation
Potential Condition.
Based on the provided information, it's challenging to make a definitive diagnosis with the given laboratory results and clinical presentation. The client's symptoms, such as severe abdominal pain, vomiting, dyspnea, yellow sclera, dry mucous membranes, tachycardia, and positive Chvostek and Trousseau signs, suggest a complex clinical picture that requires further investigation and assessment. Action to Take 1: Notify the provider. Rationale: The client's condition appears to be critical and requires immediate medical attention. Notifying the provider will initiate a comprehensive evaluation and potential interventions. Action to Take 2: Withhold medication for diarrhea until the underlying cause is determined. Rationale: Diarrhea can be a symptom of various conditions, and administering medication without a clear diagnosis may mask important clinical information. Parameters to Monitor 1: Serum bicarbonate level.
Rationale:
Monitoring serum bicarbonate levels can help identify potential acid-base imbalances and assess the client's metabolic status, especially given the history of end-stage renal disease. Parameters to Monitor 2: Intake and Output. Rationale: Monitoring intake and output is essential to assess fluid balance and kidney function, especially in a client with end- stage renal disease and potential electrolyte imbalances.
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