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A patient has been admitted with dehydration and is prescribed IV fluids and medications. Over a 12-hour shift, the following intake and output data are recorded:

Intake:

1,000 mL of lactated Ringer's administered via IV over 8 hours. 250 mL of an antibiotic infusion.

The patient drank 3 cups of water (1 cup = 240 mL).

Output:

Urine output was 1,200 mL. The patient vomited 300 mL.

Wound drainage amounted to 150 mL.

Calculate the net fluid balance

Answer and Explanation

The Correct Answer is ["320"]

Net fluid balance = Total intake - Total output

Rationale:

Total intake:

IV fluids: 1,000 mL

Antibiotic infusion: 250 mL

Oral intake: 3 cups x 240 mL = 720 mL

Total intake = 1,000 + 250 + 720 = 1,970 mL Total output:

Urine: 1,200 mL

Vomiting: 300 mL Wound drainage: 150 mL

Total output = 1,200 + 300 + 150 = 1,650 mL

Net fluid balance = 1,970 mL - 1,650 mL = +320 mL

The patient has a positive fluid balance of 320 mL.

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Correct Answer is B

Explanation

A. Elevated ketones in the urine can indicate diabetic ketoacidosis or starvation but is not specific to a UTI.
B. Nitrites are commonly found in the urine of patients with UTIs due to bacterial conversion of urinary nitrates to nitrites. This is a hallmark finding of a UTI.
C. Low specific gravity indicates diluted urine, which is not a direct indicator of a UTI.
D. Glucose in the urine could indicate diabetes but is not a typical finding for a UTI.

A. "It is important to follow up with a GI specialist for recommended surveillance for Barrett's esophagus". B. "It is important to watch for manifestations of pancreatic cancer." C. "Follow-up with an endocrinologist as your risks for diabetes increases." D. "You will need to monitor for manifestations of liver issues."

Correct Answer is A

Explanation

A. Barrett's esophagus is a complication of GERD and is associated with an increased risk of esophageal cancer. It is essential for the patient to follow up with a GI specialist for surveillance.
B. Pancreatic cancer is not directly related to GERD, so the nurse should not suggest watching for symptoms of this condition.
C. Diabetes risk is not directly increased by GERD. Therefore, follow-up with an endocrinologist is unnecessary unless the patient has other risk factors for diabetes.
D. Liver issues are not typically associated with GERD, so monitoring for liver problems would not be a primary concern in this case.

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Rationale:

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