A nurse is collecting data for a client who is receiving enteral tube feedings. The nurse should identify that which of the following findings is a manifestation of fluid overload?
Weight loss
Decreased blood pressure
Decreased skin turgor
Crackles heard in the lungs
The Correct Answer is D
A. Incorrect. Weight loss is not a manifestation of fluid overload but rather of insufficient nutrition.
B. Incorrect. Decreased blood pressure is not a manifestation of fluid overload but could indicate hypovolemia.
C. Incorrect. Decreased skin turgor is a sign of dehydration, not fluid overload.
D. Correct. Crackles heard in the lungs can indicate fluid overload in the lungs, also known as pulmonary edema. This is often caused by an excess of fluid in the body.
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Related Questions
Correct Answer is D
Explanation
A. Blood urea nitrogen measures kidney function, is not related to thyroid health.
B. Arterial blood gases are used to assess oxygen and carbon dioxide levels in the blood, not related to thyroid health.
C. Prothrombin time is a test used to assess blood clotting, not related to thyroid health.
D. Correct. Monitoring thyroid stimulating hormone (TSH. levels is crucial for assessing the function of the thyroid gland and adjusting levothyroxine dosage as needed.
Correct Answer is D
Explanation
A. Remaining in bed until falling asleep can worsen insomnia and create negative associations with the bed.
B. While maintaining a consistent sleep schedule is important, sleeping longer on the weekends can disrupt the circadian rhythm.
C. Keeping the television volume low can help with sleep, but it might not directly address the underlying issue of trouble falling asleep.
D. Correct. Regular exercise, especially during the day, can help regulate sleep patterns and improve the ability to fall asleep at night.
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