A nurse is assessing a client who has heart failure and is taking furosemide. Which of the following findings should indicate to the nurse that the client is experiencing fluid volume deficit?

Distended neck veins

Elevated hematocrit level

Shortness of breath

Weight gain

Answer and Explanation

The Correct Answer is B

Distended neck veins: Distended neck veins are typically associated with fluid volume excess rather than deficit. In heart failure, venous congestion can cause jugular venous distention, indicating fluid volume overload rather than deficit. Therefore, this finding would not suggest fluid volume deficit in a client with heart failure receiving furosemide.
B) Elevated hematocrit level: Fluid volume deficit, also known as dehydration or hypovolemia, is characterized by a loss of both water and electrolytes from the body, leading to a relative increase in the concentration of red blood cells and other blood components. This increase in concentration results in an elevated hematocrit level, which is a common laboratory finding in clients with fluid volume deficit. Furosemide, a loop diuretic, is commonly used to manage fluid overload in clients with heart failure by promoting diuresis and reducing excess fluid retention. However, excessive diuresis with furosemide can lead to fluid volume deficit if not adequately monitored and managed.

C) Shortness of breath: Shortness of breath is a common symptom of heart failure, particularly when fluid accumulates in the lungs (pulmonary edema) due to fluid volume overload. While shortness of breath may be present in both fluid volume deficit and excess, it is more commonly associated with fluid volume overload in clients with heart failure.

D) Weight gain: Weight gain is indicative of fluid volume excess rather than deficit. In heart failure, weight gain often occurs due to fluid retention, reflecting an increase in total body water and extracellular fluid volume. Monitoring weight is essential in managing heart failure and assessing fluid status, but weight gain would not suggest fluid volume deficit in a client receiving furosemide for heart failure management.

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Correct Answer is B

Explanation

A) "Pour expire” medication tablets into a w“ste basket": This is an incorrect statement. Pourin” expired medication into a waste basket can pose a risk of accidental ingestion by children, pets, or individuals who may go through the trash. It is not a safe method of medication disposal.

B) "Return expired medication to the pharmac“st": This is the correct action for safe me”ication disposal. Many pharmacies have programs for the safe disposal of unused or expired medications. Returning medications to the pharmacist ensures proper disposal and prevents environmental contamination or misuse.

C) "Discard expired medication down the toil“t": This is an incorrect statement. Flushi”g medication down the toilet can contribute to water pollution and harm aquatic life. It is not recommended as a method of medication disposal unless specifically instructed for certain controlled substances by authorized entities.

D) "Crush expired medication tablets and rin“e them down the sink": This is an incorrect statement. Crushi”g medication tablets and rinsing them down the sink can introduce pharmaceuticals into the water supply, which can have adverse effects on aquatic ecosystems. It is not a safe or environmentally friendly method of disposal.

A. "The TPN will stimulate your appetite so that you'll be able to eat more food." B. "The TPN contains medication that will help your digestive tract absorb nutrients." C. "The TPN will provide nutrients while your bowels have time to rest." D. "The TPN will help keep your bowels clear in case you need surgery."

Correct Answer is C

Explanation

C) "The TPN will provide nutrients while your bowels have time to rest": Total parenteral nutrition (TPN) is a method of providing nutrition intravenously to clients who are unable to tolerate or absorb adequate nutrients through the gastrointestinal tract. It bypasses the digestive tract entirely, delivering a balanced mixture of nutrients directly into the bloodstream. One of the primary indications for TPN is to provide nutritional support while allowing the gastrointestinal tract to rest, particularly in cases where the bowels are inflamed, injured, or unable to function properly. By bypassing the digestive system, TPN can provide essential nutrients to the body while reducing the workload on the gastrointestinal tract. Therefore, the nurse should include this information in the teaching to help the client understand the purpose and benefits of TPN therapy.

A) "The TPN will stimulate your appetite so that you'll be able to eat more food": TPN does not stimulate appetite. In fact, TPN is often used when the client cannot eat or tolerate oral intake due to various medical conditions or gastrointestinal issues. Therefore, this statement is incorrect and may confuse the client about the purpose of TPN therapy.

B) "The TPN contains medication that will help your digestive tract absorb nutrients": TPN does not contain medication to help the digestive tract absorb nutrients. Instead, TPN provides nutrients directly into the bloodstream, bypassing the need for digestion. This statement is inaccurate and does not accurately describe the mechanism of action of TPN.

D) "The TPN will help keep your bowels clear in case you need surgery": While TPN can help maintain nutritional status in clients who are unable to eat or tolerate oral intake, it is not primarily used to keep the bowels clear for surgery. Bowel preparation for surgery typically involves other interventions such as bowel rest, mechanical cleansing, or medication administration. Therefore, this statement is not directly related to the purpose of TPN therapy and may mislead the client about its intended use.

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A nurse is assessing a client who has heart failure and is taking furosemide. Which of the following findings should indicate to the nurse that the client is experiencing fluid volume deficit?

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