An adult female client has a body mass index of 34.5 kg/m2 and has expressed interest in bariatric surgery. What characteristic of the client's health status may exclude her from being an appropriate surgical candidate?

Choice A reason: This is not a correct answer because 0.9% Sodium Chloride is an isotonic solution, which means it has the same osmolarity as the blood plasma. It does not cause any fluid shifts between the intracellular and extracellular compartments.

Choice B reason: This is not a correct answer because Lactated Ringer's is an isotonic solution, which means it has the same osmolarity as the blood plasma. It does not cause any fluid shifts between the intracellular and extracellular compartments.

Choice C reason: This is not a correct answer because D5W (5% Dextrose in Water) is an isotonic solution when it is in the IV bag, but it becomes hypotonic once it enters the body, as the dextrose is rapidly metabolized and only water remains. However, it is not a preferred solution for a patient with critically high sodium, as it can cause cerebral edema and worsen the neurological status.

Choice D reason: This is a correct answer because 0.45% Sodium Chloride is a hypotonic solution, which means it has a lower osmolarity than the blood plasma. It causes fluid to shift from the extracellular to the intracellular compartment, which can help lower the sodium level and correct the fluid imbalance.

Choice A reason: This is not a correct finding for hypovolemia. Peripheral edema is the swelling of the extremities due to fluid accumulation in the interstitial spaces. It is a sign of fluid volume excess, not fluid volume deficit.

Choice B reason: This is not a correct finding for hypovolemia. Bradycardia is a slow heart rate, usually below 60 beats per minute. It is not a typical sign of fluid volume deficit, as the heart rate usually increases to compensate for the low blood pressure and low cardiac output.

Choice C reason: This is not a correct finding for hypovolemia. Hypertension is a high blood pressure, usually above 140/90 mmHg. It is not a typical sign of fluid volume deficit, as the blood pressure usually decreases due to the reduced blood volume and vascular resistance.

Choice D reason: This is a correct finding for hypovolemia. Decreased urine output is a sign of fluid volume deficit, as the kidneys try to conserve water and electrolytes by reducing the urine production. The normal urine output is about 30 mL per hour, and anything below 20 mL per hour is considered oliguria, which indicates impaired renal function.