A nurse is teaching a class about administering IV fluids to treat dehydration. Which of the following findings should the nurse include in the teaching as an indicator of effective treatment of dehydration?

Postoperative pain management requires rapid onsetof action to maintain the client within a therapeutic comfort window. During the immediate post-anesthesiaperiod (the first 24 hours), the gastrointestinal tract may have decreased motility, making systemic absorption via the bloodstream the most reliable method. Effective analgesia is crucial for early mobilization and preventing complications like venous thromboembolism.

Rationale:

A.The intravenous route is the priority for a client who is only 6 hours postoperative because it provides immediate bioavailability and rapid peak effect. Following a major orthopedic surgery like a hip fixation, pain levels are typically high and require the fast-acting relief that IV opioids or non-opioids provide. This route allows for precise titration of the medication based on the client’s immediate pain response.

B.The oral route is generally avoided in the very early postoperative period due to the risk of postoperative ileus and nausea related to anesthesia. Oral medications have a slower onset of action, typically taking 30 to 60 minutes to reach peak effect, which is insufficient for acute, severe surgical pain. This route is more appropriate once the client is stable and bowel sounds have returned.

C.Sublingual administration is useful for certain medications but is not the standard of care for acute postoperative pain following major surgery. Most potent surgical analgesics are not formulated for sublingual use. The nurse requires a route that can deliver a wide range of analgesic agents reliably, making the intravenous route superior for the immediate recovery phase of a hip surgery.

D.The intramuscular route is generally discouraged for postoperative pain because it is painful, results in inconsistent absorption, and has a slower onset than the intravenous route. Repeated IM injections can cause tissue damage and hematomas, especially in surgical clients who may be on anticoagulants. Modern nursing practice favors IV access for acute pain to ensure consistent and rapid relief.

Furosemide is a potent loop diureticthat inhibits sodium and chloride reabsorption in the ascending limbof the loop of Henle. By promoting the excretion of water and electrolytes, it reduces circulatory overloadand alleviates pulmonary congestion associated with acute decompensated heart failure.

Rationale:

A.Furosemide typically causes a decrease in blood pressure rather than an increase, as it reduces total circulating blood volume. While stabilizing heart failure may eventually improve cardiac output, the immediate effect of diuretic therapy is a reduction in preload and systemic pressure. An increase in blood pressure would not be a direct indicator of successful diuresis.

B.Decreased weight is the most reliable indicator of effective diuretic therapy because it reflects the loss of excess interstitial and intravascular fluid. In acute heart failure, rapid diuresis leads to the excretion of several liters of fluid, manifesting as a significant daily weight drop. The nurse monitors daily weights as a precise quantitative measure of the client's response to loop diuretics.

C.Loop diuretics like furosemide typically cause the excretion of sodium, which can lead to hyponatremia rather than an increase in sodium levels. Elevated sodium would suggest dehydration or inadequate water excretion, which is contrary to the goal of heart failure management. The nurse should monitor for electrolyte depletion as a side effect of the treatment's success.

D.Furosemide does not directly decrease blood glucose levels; in fact, loop diuretics can occasionally cause hyperglycemia or impaired glucose tolerance. A decrease in blood glucose is not a parameter used to evaluate the efficacy of fluid removal in heart failure. The nurse should focus on respiratory status, urine output, and weight changes to assess the medication's therapeutic impact.