A patient with fluid volume overload is admitted to the hospital for diuresis. Which assessment should the nurse perform to evaluate the patient's fluid balance?
Skin turgor.
Weight.
Blood pressure.
Lung sounds.
The Correct Answer is B
Choice A reason: Skin turgor is a method to assess hydration status, but it is not the most accurate indicator of fluid balance in a patient with fluid volume overload.
Choice B reason: Monitoring weight is the most accurate method to assess fluid balance. A sudden increase or decrease in weight is indicative of fluid changes.
Choice C reason: Blood pressure can be affected by fluid volume changes, but it does not provide a direct measure of fluid balance.
Choice D reason: Lung sounds can indicate fluid overload in the lungs but do not give a complete picture of overall fluid balance.

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Related Questions
Correct Answer is C
Explanation
Choice A reason: While bowel incontinence is a concern, it does not pose an immediate threat to the client's physiological stability like fluid volume deficit does.
Choice B reason: Impaired bed mobility is important to address for long-term rehabilitation, but it is not the most immediate threat to life.
Choice C reason: Fluid volume deficit, especially due to diarrhea, can lead to dehydration and is a life-threatening condition that requires immediate intervention.
Choice D reason: Caregiver role strain is a significant issue but does not take precedence over the client's immediate physical health needs.
Correct Answer is D
Explanation
Choice A reason: Leaving the dressing off is not advisable as it can expose the wound to potential infection and delay healing.
Choice B reason: A transparent dressing may not be the best choice for a stage 3 pressure injury with significant granulation tissue.
Choice C reason: Increasing the frequency of dressing changes without specific orders may not be necessary and could disrupt the healing process.
Choice D reason: A hydrocolloid gel dressing is appropriate for a stage 3 pressure injury as it maintains a moist environment, which is conducive to wound healing and granulation.
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