Which method is best for the nurse to use in determining early development of ascites?

Inspection of the abdomen for enlargement,

Palpation of an abdominal fluid wave.

Bimanual palpation for liver enlargement.

Successive measurements of abdominal girth.

Answer and Explanation

The Correct Answer is B

A. Inspection of the abdomen for enlargement: Ascites causes abdominal distention. Inspection is a straightforward way to assess for fluid accumulation.

B. Palpation of an abdominal fluid wave: Palpating for a fluid wave (shifting of fluid within the abdomen) is a classic sign of ascites.

C. Bimanual palpation for liver enlargement: While liver enlargement can contribute to ascites, it is not the primary method for detecting early ascites.

D. Successive measurements of abdominal girth: Regular measurements of abdominal girth help track changes over time and detect early ascites.

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Correct Answer is D

Explanation

A. Takes a first step alone: This is typically achieved closer to 12 months.

B. Sits alone unsupported: Some 8-month-olds might achieve this, but pulling to sit is a more consistent milestone at this age.

C. Can feed self finger food: While some babies might explore finger foods at 8 months, independent feeding is usually a skill developed later.

D. Pulls self to sitting position: This demonstrates developing upper body strength and coordination, commonly seen around 8-9 months.

A. Advise the PN that waist circumference measurements are valuable to assess fluid retention but not obesity. B. Instruct the PN to measure the client's waist circumference every 8 hours to assess for changes. C. Tell the PN that this assessment technique should be performed by the nurse. D. Review the measurement obtained by the PN and compare with ideal measurements for this client.

Correct Answer is D

Explanation

A. Advise the PN that waist circumference measurements are valuable to assess fluid retention but not obesity. Waist circumference is actually a valuable measure for assessing abdominal obesity, which is an important factor in health, independent of BMI. It helps screen for health risks related to overweight and obesity, such as heart disease and type 2 diabetes. Therefore, this option is incorrect.

B. Instruct the PN to measure the client’s waist circumference every 8 hours to assess for changes. Measuring waist circumference does not require frequent assessments like every 8 hours. It’s a simple and inexpensive measurement that provides valuable information about abdominal fat distribution. However, such frequent measurements are unnecessary and impractical for assessing obesity-related risks.

C. Tell the PN that this assessment technique should be performed by the nurse. Waist circumference measurements can be performed by practical nurses (PNs) and other healthcare providers. It’s a straightforward technique that doesn’t require specialized training. Therefore, this option is incorrect.

D. Review the measurement obtained by the PN and compare with ideal measurements for this client. This is the most appropriate action. The nurse should review the PNs measurement of the client’s waist circumference and compare it to established guidelines. Generally, a waist circumference greater than 35 inches for women or greater than 40 inches for men indicates increased risk of obesity-related health problems.

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Which method is best for the nurse to use in determining early development of ascites?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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