The nursing diagnosis of Excess Fluid Volume is made for a patient with chronic kidney disease. Which of the following data is most important for the nurse to collect for this patient based on the nursing diagnosis?
daily weight
vital signs
intake and output
skin turgor
The Correct Answer is C
A. Daily weight monitoring is important for assessing fluid status but may not provide real-time information about fluid balance changes.
B. Vital signs are important for overall assessment but may not specifically address the nursing diagnosis of Excess Fluid Volume unless there are significant changes indicative of fluid overload or dehydration.
C. Monitoring intake and output provides direct information about fluid balance and renal function, helping to identify trends and assess the effectiveness of interventions aimed at managing fluid volume.
D. Skin turgor assessment is useful for evaluating hydration status but may not provide comprehensive data on fluid volume excess alone.
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Related Questions
Correct Answer is B
Explanation
A. While controlling carbohydrate intake may be beneficial for managing blood glucose levels in some cases, it is not a primary dietary concern for chronic kidney disease.
B. Patients with chronic kidney disease often need to limit potassium intake because the kidneys may have difficulty excreting excess potassium, leading to hyperkalemia.
C. While protein restriction may be necessary in advanced stages of chronic kidney disease to reduce the workload on the kidneys, complete elimination of protein is not recommended.
D. Sodium restriction is often recommended for patients with chronic kidney disease to help control blood pressure and fluid balance.
Correct Answer is C
Explanation
A. While anemia may weaken the immune system, it is not directly associated with an increased risk of urinary tract infections.
B. Osteoporosis is a bone-related condition and is not directly related to the risk of urinary tract infections.
C. Diabetes mellitus increases the risk of urinary tract infections due to elevated glucose levels in the urine, which provide a favorable environment for bacterial growth.
D. Chronic obstructive pulmonary disease (COPD) is not directly associated with an increased risk of urinary tract infections.
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