A nurse is caring for a 68-kg (150-lb) client who has dehydration. Which of the following manifestations is an indication of effective treatment?

Urine specific gravity 1.005 to 1.030

Decreased pulse pressure

Lightheadedness

Urine output 75 mL in 1 hr

Answer and Explanation

The Correct Answer is D

The correct answer is D. Urine output 75 mL in 1 hr.

Adequate urine output (at least 30 mL/hr) indicates effective hydration, showing that the kidneys are functioning properly and fluid balance is improving. A urine output of 75 mL in 1 hour suggests sufficient fluid replacement.

Here’s why the other options are incorrect:

A. Urine specific gravity 1.005 to 1.030 – This range covers both normal and abnormal values. In dehydration, urine specific gravity is usually high (>1.030) due to concentrated urine. Effective treatment should lead to lower urine specific gravity, but the full range does not confirm improvement.
B. Decreased pulse pressure – Pulse pressure is the difference between systolic and diastolic blood pressure. Dehydration typically causes a narrowed pulse pressure, so improvement should lead to a normal or increased pulse pressure rather than a decrease.
C. Lightheadedness – Dizziness and lightheadedness are signs of dehydration-related hypotension. Effective hydration should resolve these symptoms, not maintain them.

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Correct Answer is C

Explanation

Choice A reason: pH 7.30 with elevated HCO3- and PaCO2 suggests compensated respiratory acidosis, not typical for chronic kidney disease.

Choice B reason: pH 7.55 with elevated HCO3- and low PaCO2 suggests metabolic alkalosis, which is not typical for chronic kidney disease.

Choice C reason: pH 7.25 with decreased HCO3- and PaCO2 suggests metabolic acidosis, which is expected in chronic kidney disease due to the accumulation of acids.

Choice D reason: pH 7.50 with low HCO3- and PaCO2 suggests compensated metabolic alkalosis, which is not typical for chronic kidney disease.

A. pH 7.26, HCO3 24, PaCO2 46 B. pH 7.49, HCO3 30, PaCO2 40 C. pH 7.49, HCO3 24, PaCO2 30 D. pH 7.26, HCO3 14, PaCO2 30

Correct Answer is D

Explanation

Choice A reason: A pH of 7.26 indicates acidosis, but an HCO3 of 24 and PaCO2 of 46 suggest a respiratory cause rather than metabolic, which is not typical for AKI.

Choice B reason: A pH of 7.49 indicates alkalosis, and with an HCO3 of 30 and PaCO2 of 40, this suggests metabolic alkalosis, which is not expected in AKI.

Choice C reason: A pH of 7.49 indicates alkalosis. An HCO3 of 24 is normal, and a PaCO2 of 30 would suggest respiratory alkalosis, not typically associated with AKI.

Choice D reason: A pH of 7.26 indicates acidosis, and with an HCO3 of 14, this suggests metabolic acidosis, which is consistent with AKI. The PaCO2 of 30 indicates a compensatory respiratory response to the metabolic acidosis. This ABG result aligns with the expected findings in a patient with AKI, where there is an accumulation of acids and a decrease in bicarbonate due to the kidneys' inability to filter and excrete hydrogen ions effectively.

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A nurse is caring for a 68-kg (150-lb) client who has dehydration. Which of the following manifestations is an indication of effective treatment?

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