A nurse is assessing four clients for fluid balance. The nurse should identify that which of the following manifestations of dehydration?
A.
A client who has a urine specific gravity of 1.010. (Reference Range 1.005-1.030)
B.
A client who has a hematocrit of 42%. (Reference Range 36-46%)
C.
A client who has a temperature of 39 °C.
D.
A client who has a weight loss of 2.2 kg in 24 hr.
The Correct answer and Explanation is:
The correct answer is D: A client who has a weight loss of 2.2 kg in 24 hours.
Explanation:
Dehydration occurs when the body loses more fluids than it takes in, leading to an imbalance in fluid levels. Manifestations of dehydration can include changes in vital signs, laboratory values, and physical symptoms. Here’s how each option relates to dehydration:
A. Urine Specific Gravity of 1.010: Urine specific gravity measures the concentration of solutes in urine. A specific gravity of 1.010 is within the normal reference range of 1.005-1.030. Generally, in dehydration, urine specific gravity is elevated, often exceeding 1.020, because the kidneys concentrate urine to conserve water. Therefore, this value does not indicate dehydration.
B. Hematocrit of 42%: Hematocrit is the percentage of blood volume occupied by red blood cells. The normal range for adults is typically between 36% and 46%. A hematocrit of 42% falls within this normal range. In dehydration, hematocrit levels may be elevated due to hemoconcentration, but a value within the normal range does not necessarily indicate dehydration.
C. Temperature of 39 °C: A temperature of 39 °C (102.2 °F) is indicative of fever, which could be due to an infection or other causes, rather than dehydration alone. While dehydration can lead to an elevated body temperature, fever by itself is not a specific marker of dehydration.
D. Weight Loss of 2.2 kg in 24 Hours: Significant weight loss is a clear indicator of fluid loss. A weight loss of 2.2 kg (approximately 4.8 lbs) in 24 hours is substantial and likely reflects a corresponding loss of body fluids. Weight changes are a direct and effective measure of fluid balance, and rapid weight loss is a common sign of dehydration. Typically, 1 kg of weight loss is roughly equivalent to 1 liter of fluid loss. Therefore, a weight loss of 2.2 kg suggests a significant amount of fluid loss consistent with dehydration.
In summary, the most indicative manifestation of dehydration among the options provided is the significant weight loss of 2.2 kg in 24 hours, as it directly reflects fluid loss.