A nurse is assessing a client who has fluid volume deficit. The nurse should expect which of the following findings?
A.
Increased BUN
B.
Increased urine ketones
C.
Decreased urine specific gravity
D.
Decreased Hgb
The correct answer and Explanation is :
The correct answer is A. Increased BUN.
Explanation
Fluid volume deficit, also known as dehydration or hypovolemia, occurs when there is a loss of fluids from the body, which can lead to a decrease in blood volume and subsequent impacts on various physiological functions. When assessing a client with fluid volume deficit, several laboratory and clinical findings can be expected:
- Increased BUN (Blood Urea Nitrogen): The BUN level is a measure of kidney function and the body’s ability to excrete nitrogenous waste products. When a person is dehydrated, the kidneys concentrate urine, leading to a relative increase in BUN. This is because, in a state of fluid volume deficit, there is less fluid available to dilute urea in the blood. As a result, the BUN concentration rises, indicating dehydration or fluid volume deficit.
- Increased urine ketones: This is not a primary indicator of fluid volume deficit. Increased urine ketones are more commonly associated with conditions like diabetic ketoacidosis or starvation, where there is increased fat metabolism and ketone production. While dehydration can accompany these conditions, it is not a direct indicator of fluid volume deficit.
- Decreased urine specific gravity: Fluid volume deficit typically leads to increased urine specific gravity, not decreased. Urine specific gravity measures the concentration of solutes in urine. In dehydration, the kidneys conserve water and excrete a more concentrated urine, which increases urine specific gravity.
- Decreased Hgb (Hemoglobin): Fluid volume deficit usually does not cause a decrease in hemoglobin levels. In fact, hemoglobin concentration can appear normal or even increase in the context of dehydration due to hemoconcentration. Decreased hemoglobin is more likely associated with anemia or blood loss rather than fluid volume deficit alone.
In summary, the most relevant finding in a client with fluid volume deficit is an increased BUN due to the concentration of waste products in the blood resulting from reduced fluid volume.