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
An erythrocyte sedimentation rate (ESR) is a blood test that can detect and monitor inflammation in the body. It measures the rate at which red blood cells (erythrocytes) in a test tube separate from blood serum over time, with the rate being faster in people with inflammatory diseases. While it can be elevated in many conditions, including liver disease, it is not specific to liver disease and therefore would not typically be used to confirm a diagnosis of liver disease.
Choice B rationale
D-dimer is a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is typically used to rule out thrombosis (blood clots), not to diagnose liver disease.
Choice C rationale
C-reactive protein (CRP) is a protein made by the liver and sent into the bloodstream in response to inflammation. While it can be elevated in many conditions, including liver disease, it is not specific to liver disease and therefore would not typically be used to confirm a diagnosis of liver disease.

Choice D rationale
Albumin is a protein made by the liver, and measuring its levels can help diagnose liver disease. When the liver is damaged, it can’t make enough albumin, so the level of albumin in the blood gets lower. This is why albumin is often used as a marker of liver function, and why it would be anticipated in the laboratory values ordered to confirm a diagnosis of liver disease.
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Choice A rationale
While having a room within view of the nurses’ station can be beneficial for monitoring the patient, it does not specifically address the needs of a patient with active tuberculosis.
Choice B rationale
Placing a patient with active tuberculosis in a room with another non-surgical patient could potentially expose the other patient to the disease. Tuberculosis is an airborne disease and can easily spread to others in close proximity.
Choice C rationale
A room with air exhaust directly to the outdoor environment is the most appropriate choice for a patient with active tuberculosis. This type of room, known as a negative pressure room, helps prevent the spread of airborne diseases like tuberculosis. The air in the room is vented outside, reducing the risk of the disease spreading to other areas of the hospital.
Choice D rationale
While the ICU is equipped to handle severe and critical cases, a patient with active tuberculosis does not necessarily need to be in the ICU unless they are critically ill. Moreover, placing them in the ICU could potentially expose other critically ill patients to tuberculosis.