A nurse is caring for four hospitalized patients.
Which of the following patients should the nurse identify as being at risk for fluid volume deficit?

Choice A rationale
While a hiatal hernia can cause discomfort and other symptoms, it does not directly increase the risk for stomach cancer.
Choice B rationale
A hiatal hernia might increase your risk for Gastroesophageal Reflux Disease (GERD). This is because the hernia can cause the lower esophageal sphincter to malfunction, allowing stomach acid to flow back into the esophagus, which is the main cause of GERD1.
Choice C rationale

A hiatal hernia does not directly increase the risk for lung disease. However, if the hernia is large, it could potentially cause breathing difficulties or exacerbate existing respiratory conditions.
Choice D rationale
A hiatal hernia does not increase the risk for intestinal cancer. The hernia occurs in the diaphragm, which is separate from the intestines.

Choice A rationale
While emotional concerns are important to address in a holistic care approach, they are not the initial course of action when a client is admitted due to an acute exacerbation of ulcerative colitis. Emotional concerns are usually addressed once the client’s physical condition is stabilized.
Choice B rationale
Checking the client’s perianal skin integrity is a crucial initial step when a client is admitted due to an acute exacerbation of ulcerative colitis. Ulcerative colitis can cause rectal bleeding and diarrhea, which can lead to skin breakdown in the perianal area. Therefore, assessing for skin integrity helps in early detection and management of potential skin complications.
Choice C rationale
Obtaining a dietary history from the client is important but not the initial course of action in this scenario. Dietary history is usually obtained once the client’s condition is stabilized and when planning for discharge or dietary modifications.
Choice D rationale
Reviewing the client’s electrolyte values is important in managing ulcerative colitis, but it’s not the initial course of action. Electrolyte imbalances can occur due to diarrhea and

malabsorption, which are common in ulcerative colitis. However, this is usually done after initial physical assessments and stabilization of the client.