A nurse in a community clinic is collecting data from an older adult client who has a body mass index of 17.5. When evaluating the client for dehydration, the nurse should look for which of the following indications of fluid-volume deficit?

A. Provide a diet high in protein.

During the oliguric phase of acute kidney injury (AKI), there is a risk of electrolyte imbalances, including elevated levels of blood urea nitrogen (BUN) and creatinine. Restricting protein intake is often recommended during this phase to manage azotemia and prevent the accumulation of waste products that the kidneys may struggle to excrete.

B. Provide ibuprofen for retroperitoneal discomfort.

Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated in AKI. They can further compromise renal function and may contribute to acute tubular necrosis. NSAIDs can also affect renal blood flow, leading to worsening kidney function.

C. Monitor intake and output hourly.

Monitoring intake and output (I&O) is a critical nursing intervention during the oliguric phase of AKI. Hourly monitoring helps assess renal function, fluid balance, and the effectiveness of interventions. It allows for early detection of changes that may require prompt intervention.

D. Encourage the client to consume at least 2 L of fluid daily.

In the oliguric phase of AKI, fluid intake is often restricted to prevent fluid overload. Encouraging excessive fluid intake may contribute to fluid retention and worsen the oliguria. Fluid management is carefully regulated based on the individual client's needs and renal function.

A. “Most of my calories each day should be from fats.”

This statement is not accurate. While fats are essential for a balanced diet, it is not recommended for the majority of calories to come from fats. The emphasis should be on a variety of macronutrients, including carbohydrates and proteins.

B. “I should eat more calories from complex carbohydrates than anything else.”

This is the correct choice. Individuals with diabetes are often encouraged to obtain the majority of their calories from complex carbohydrates. These include whole grains, vegetables, and legumes, which have a slower impact on blood glucose levels.

C. “Simple sugars are needed more than other calorie sources.”

This statement is not accurate for individuals with diabetes. Simple sugars can lead to rapid spikes in blood glucose levels and should be consumed in moderation.

D. “Protein should be my main source of calories.”

This statement is not accurate. While protein is important for overall health, it is not recommended for protein to be the main source of calories. A balanced diet with an emphasis on complex carbohydrates is typically recommended.