A nurse is teaching a client who is on a low-sodium diet. Which of the following instructions should the nurse include? (Select all that apply.)

Limit intake of canned soups.

Choose botled salad dressings.

Choose diet sodas over botled water.

Replace processed meats with fresh meat products.

Read labels on foods before eating.

Answer and Explanation

Correct Answer : A,D,E

Choice A: Limit intake of canned soups is correct because canned soups are high in sodium and can increase blood
pressure and ﬂuid retention. The nurse should advise the client to choose low-sodium or homemade soups instead.

Choice B: Choose botled salad dressings is incorrect because botled salad dressings are also high in sodium and can have added sugars and fats. The nurse should advise the client to make their own salad dressings with vinegar, oil, herbs, and spices.

Choice C: Choose diet sodas over botled water is incorrect because diet sodas are not a healthy alternative to water. Diet sodas contain artificial sweeteners, caﬀeine, and phosphoric acid, which can aﬀect the body's pH balance and calcium absorption. The nurse should advise the client to drink plain water or ﬂavored water with natural ingredients.

Choice D: Replace processed meats with fresh meat products is correct because processed meats such as bacon, ham, sausage, and hot dogs are high in sodium and preservatives. The nurse should advise the client to choose fresh meat products such as chicken, turkey, fish, or lean beef.

Choice E: Read labels on foods before eating is correct because reading labels can help the client identify the sodium content and other ingredients in foods. The nurse should advise the client to look for foods that have less than 140 mg of sodium per serving and avoid foods that have salt, sodium, or monosodium glutamate (MSG) in the ingredient list.

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Correct Answer is B

Explanation

Choice A: Concentrated hemoglobin and hematocrit levels are not a sign of ﬂuid volume overload, but rather of ﬂuid volume deficit. This is a condition that occurs when the body loses more ﬂuid than it gains. This can happen in patients who have excessive bleeding, vomiting, diarrhea, or diaphoresis. Concentrated hemoglobin and hematocrit levels indicate hemoconcentration, which is an increase in the ratio of blood cells to plasma.

Choice B: Distended neck veins are a sign of ﬂuid volume overload, because this condition occurs when the body retains more ﬂuid than it excretes. This can happen in patients who have heart failure, kidney failure, or excessive ﬂuid intake. Distended neck veins indicate increased central venous pressure, which is a measure of the pressure in the right atrium of the heart.

Choice C: Decreased urine output is not a sign of ﬂuid volume overload, but rather of oliguria or anuria. These are conditions that occur when the urine output is less than 400 mL or 50 mL per day, respectively. These can happen in patients who have acute or chronic kidney injury, urinary obstruction, or shock. Decreased urine output indicates impaired renal function and decreased glomerular filtration rate.

Choice D: Poor skin turgor is not a sign of ﬂuid volume overload, but rather of dehydration. This is a condition that occurs when the body loses more water than it gains. This can happen in patients who have fever, diabetes insipidus, or hyperglycemia. Poor skin turgor indicates decreased skin elasticity and delayed return to normal shape after being pinched.

A. Increased BUN B. Increased urine ketones C. Decreased urine specific gravity D. Decreased Hgb

Correct Answer is A

Explanation

Choice A Reason: This is correct because BUN stands for blood urea nitrogen, which is a waste product of protein metabolism that is excreted by the kidneys. Increased BUN indicates ﬂuid volume deficit, as the blood becomes more concentrated and the kidneys have less ﬂuid to filter. A normal BUN level is 7 to 20 mg/dL. The nurse should monitor the client's ﬂuid intake and output, weight, and serum electrolytes, and administer ﬂuids as ordered.

Choice B Reason: This is incorrect because urine ketones are not related to ﬂuid volume deficit, but to diabetic ketoacidosis, which is a complication of diabetes mellitus that occurs when the body breaks down fat for energy and produces ketones as a by-product. Increased urine ketones indicate diabetic ketoacidosis, which can cause

dehydration, acidosis, and coma. A normal urine ketone level is negative or trace. The nurse should monitor the client's blood glucose, pH, and bicarbonate levels, and administer insulin and ﬂuids as ordered.

Choice C Reason: This is incorrect because urine specific gravity is a measure of the concentration of solutes in the urine. Decreased urine specific gravity indicates ﬂuid volume excess, as the urine becomes more diluted and the kidneys excrete more ﬂuid. A normal urine specific gravity range is 1.005 to 1.030. The nurse should monitor the client's ﬂuid balance, vital signs, and edema, and administer diuretics as ordered.

Choice D Reason: This is incorrect because Hgb stands for hemoglobin, which is a protein in red blood cells that carries oxygen. Decreased Hgb indicates anemia, which is a condition that occurs when the blood has a low number of red blood cells or hemoglobin. Anemia can cause fatigue, weakness, and pallor. A normal Hgb level for adult males is 14 to 18 g/dL and for adult females is 12 to 16 g/dL. The nurse should monitor the client's oxygen saturation, iron level, and blood transfusion needs, and administer iron supplements or erythropoietin as ordered.

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