The nurse is caring for a group of patients. Which patient is at highest risk for hypovolemia?

A patient who lost 2 liters of blood during surgery

A patient who received 6 liters of IV fluid

A patient with UTI on po iv meds

A patient with congestive heart failure

Answer and Explanation

The Correct Answer is A

A. A patient who lost 2 liters of blood during surgery: This is the most acute and severe form of hypovolemia due to significant blood loss, requiring immediate fluid replacement and hemodynamic monitoring.

B. A patient who received 6 liters of IV fluid: This patient is at risk for hypervolemia, not hypovolemia, due to fluid overload.

C. A patient with UTI on PO meds: While dehydration may occur, it is typically mild and does not cause hypovolemia.

D. A patient with congestive heart failure: CHF usually leads to fluid retention, making hypovolemia unlikely unless there are other complicating factors.

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Correct Answer is D

Explanation

A. Vital signs: Vital signs can reflect changes in fluid status, but they are not always sensitive to small shifts in fluid balance and can be affected by many other factors like medications.

B. Skin turgor: Skin turgor can be useful for assessing dehydration but is not a reliable indicator for tracking fluid balance over time, especially in older adults where skin elasticity naturally declines.

C. Daily input and output: Monitoring intake and output is useful, but it is not the most reliable for evaluating overall fluid balance, especially in cases of insensible loss or shifts in third spaces.

D. Daily weights: Weighing the patient daily is the most reliable method for monitoring fluid balance because it directly reflects changes in fluid retention or loss, particularly in acute or chronic conditions like heart failure or dehydration.

A. Have the laboratory draw a blood sample for an erythrocyte sedimentation rate. B. Restrict fluid intake. C. Obtain a 12-lead ECG. D. Administer potassium gluconate 40 mEq orally.

Correct Answer is C

Explanation

A. Have the laboratory draw a blood sample for an erythrocyte sedimentation rate (ESR): ESR measures inflammation and is unrelated to hyperkalemia.

B. Restrict fluid intake: Fluid restriction is not appropriate for hyperkalemia unless specifically related to fluid overload or renal failure.

C. Obtain a 12-lead ECG: Hyperkalemia can cause life-threatening cardiac dysrhythmias such as peaked T waves, widened QRS complexes, or asystole. ECG monitoring is essential.

D. Administer potassium gluconate 40 mEq orally: This would worsen hyperkalemia and is contraindicated.

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The nurse is caring for a group of patients. Which patient is at highest risk for hypovolemia?

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Naxlex Comprehensive Predictor Exams

Which is the most reliable method for monitoring improvement when restoring fluid balance?

Correct Answer is D

Explanation

A nurse is reviewing the laboratory values for a client who takes spironolactone and notes that the client's serum potassium level is 6.8 mEq/L (3.5 -5 mEq/L). The nurse notifies the provider and anticipates that the provider will provide which of the following instructions?

Correct Answer is C

Explanation

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