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?

The patient who has left-sided heart failure and has a brain natriuretic peptide (BNP) level of 600 pg/mL.

The patient who has been NPO since midnight for endoscopy.

The patient who has gastroenteritis and is febrile.

The patient who has end-stage renal failure and is scheduled for dialysis today.

Answer and Explanation

The Correct Answer is C

Choice A rationale
While heart failure can lead to fluid volume imbalances, a BNP level of 600 pg/mL alone does not indicate a risk for fluid volume deficit.
Choice B rationale

Being NPO since midnight for an endoscopy could potentially lead to fluid volume deficit, but it’s not the most likely choice. Typically, patients are adequately hydrated before and after the procedure.
Choice C rationale
A patient with gastroenteritis and a fever is at high risk for fluid volume deficit. Gastroenteritis can cause significant fluid loss through vomiting and diarrhea, and fever increases insensible water loss.
Choice D rationale
While patients with end-stage renal failure can have fluid volume imbalances, they are more likely to experience fluid volume excess, especially if they are due for dialysis.

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Correct Answer is D

Explanation

Choice A rationale
Monitoring for changes in the color of urine to maroon or red is not typically associated with peptic ulcers. This could be a sign of other conditions such as urinary tract infections, kidney stones, or certain medications.
Choice B rationale
Unintentional weight gain is not a common symptom of peptic ulcers. In fact, some people with peptic ulcers may experience weight loss due to discomfort while eating or a decrease in appetite.
Choice C rationale

The appearance of ecchymosis (bruising) on the sides of the abdomen or pelvic areas is not a typical symptom or concern with peptic ulcers. This could be a sign of trauma, certain medications, or other medical conditions.
Choice D rationale
One of the symptoms of a peptic ulcer can be changes in the color of the stool, particularly if it becomes dark or black. This can be a sign of bleeding in the gastrointestinal tract, which can occur with peptic ulcers. Therefore, patients should be advised to monitor for this symptom and seek medical attention if it occurs.

A. The client who has a nasogastric (NG) tube to suction. B. The client who has a tracheostomy tube attached to humidified oxygen. C. The client who has an indwelling urinary catheter to gravity drainage. D. The client who has a chest tube to water seal.

Correct Answer is A

Explanation

Choice A rationale
Patients with a nasogastric (NG) tube to suction are at risk for hypokalemia. Hypokalemia, or low potassium levels, can occur due to increased losses from the gastrointestinal tract, which can occur with NG tube suction. Potassium is an essential electrolyte that plays a vital role in many bodily functions, particularly in the heart and cardiovascular system. Therefore, any condition or intervention that leads to a significant loss of potassium, such as NG tube suction, can potentially lead to hypokalemia.
Choice B rationale

A tracheostomy tube attached to humidified oxygen is primarily used to help a patient breathe. It does not typically contribute to potassium loss or imbalance. Therefore, it is not likely to increase the risk of hypokalemia.
Choice C rationale
An indwelling urinary catheter to gravity drainage is used to drain urine from the bladder. While the kidneys do play a role in maintaining potassium balance, the use of a urinary catheter itself does not typically lead to significant potassium loss or increase the risk of hypokalemia.
Choice D rationale
A chest tube to water seal is used to remove air, fluid, or pus from the pleural space to help the lungs expand properly. It does not typically contribute to potassium loss or imbalance.
Therefore, it is not likely to increase the risk of hypokalemia.

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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?

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Correct Answer is D

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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?