What is the normal range of serum chloride level in adults?

Choice A reason: The client with an ileostomy is at risk for fluid volume deficit because an ileostomy is a surgical opening in the ileum, the last part of the small intestine, that allows the drainage of intestinal contents. This can result in a loss of fluids and electrolytes, especially sodium and potassium, which can lead to dehydration and hypovolemia.

Choice B reason: The client with cirrhosis is not at risk for fluid volume deficit, but rather fluid volume excess. Cirrhosis is a chronic liver disease that causes scarring and impaired liver function. This can lead to portal hypertension, which is an increase in the pressure in the portal vein that carries blood from the digestive organs to the liver. Portal hypertension can cause ascites, which is the accumulation of fluid in the abdominal cavity, and edema, which is the swelling of the tissues due to fluid retention.

Choice C reason: The client with heart failure is not at risk for fluid volume deficit, but rather fluid volume excess. Heart failure is a condition where the heart is unable to pump enough blood to meet the body's needs. This can lead to congestion of the blood vessels, which can cause pulmonary edema, which is the accumulation of fluid in the lungs, and peripheral edema, which is the swelling of the extremities due to fluid retention.

Choice D reason: The client with decreased renal function is not at risk for fluid volume deficit, but rather fluid volume excess. Decreased renal function is a condition where the kidneys are unable to filter the blood and remove excess fluids and wastes. This can lead to oliguria, which is a decrease in urine output, and anuria, which is the absence of urine output. This can cause fluid overload, which can affect the heart and the lungs.

Choice A: Elderly patients are at a higher risk for dehydration due to physiological changes that come with aging, such as decreased kidney function and physical changes to the body's water balance systems. Additionally, fever increases metabolic rate and fluid loss, and nausea and vomiting prevent adequate fluid intake, further increasing the risk of dehydration.

Choice B: While intentionally limiting fluid intake can lead to dehydration, the body's thirst mechanism in a healthy teenager is typically strong enough to prevent severe dehydration.

Choice C: Diarrhea can certainly lead to dehydration, but a young, otherwise healthy patient typically has a stronger ability to recover from fluid loss than an elderly patient.

Choice D: Infants are at a higher risk for dehydration than older children and adults due to their smaller body weight and higher turnover of water and electrolytes, but in this case, the elderly patient's multiple risk factors put them at a higher risk overall.