A nurse is collecting data on a client who is experiencing hypervolemia. Which of the following findings should the nurse expect?

A. Moist skin: Dehydration often leads to dry skin rather than moist skin. When the body is dehydrated, it conserves water, and one of the signs can be dry, less elastic skin.

B. High blood pressure: Dehydration tends to result in lower blood volume, which can lead to lower blood pressure rather than high blood pressure. However, severe dehydration may cause a drop in blood pressure.

C. Dark-colored urine: Dehydration commonly causes urine to become more concentrated, leading to darker urine. This is due to the kidneys conserving water and producing less urine.

D. Distended neck veins: Dehydration is more likely to result in decreased blood volume and lower venous return, which would not typically lead to distended neck veins. Distended neck veins are more commonly associated with conditions like heart failure.

A. Apply Neosporin to avoid infection:
This choice suggests applying Neosporin to the surgical site. However, the immediate postoperative care for cleft lip surgery often involves keeping the incision site covered with sterile dressings. Topical antibiotics may be prescribed by the healthcare provider if deemed necessary, but it's not a routine application without specific instructions.

B. Apply elbow immobilizers when not being held:
This choice implies using elbow immobilizers for the child. However, elbow immobilizers are not a standard intervention for cleft lip surgery. The focus is usually on keeping the surgical site clean and preventing complications like infection.

C. Suction secretions away from the suture line:
This is the recommended choice. Suctioning helps maintain a clear airway and prevents secretions from affecting the surgical site. It's a crucial step in the immediate postoperative period.

D. Feed increased amounts of formula to prevent weight loss:
While feeding is an essential aspect of care, especially for nutritional support, the immediate concern in the first few days after cleft lip surgery is often related to maintaining a patent airway and preventing infection. Feeding interventions might be guided by the healthcare provider's recommendations, but it's not the primary focus in the initial postoperative period.