A nurse is collecting data about the fluid status of four clients.
Which of the following clients should the nurse identify as being at risk for fluid volume deficit?
A.
A client who has NPO status since midnight for an endoscopy.
B.
A client who has heart failure and is receiving diuretic therapy.
C.
A client who has gastroenteritis and is receiving oral fluids.
D.
A client who has end-stage kidney disease who will undergo dialysis.
The Correct answer and Explanation is:
The correct answer is B: A client who has heart failure and is receiving diuretic therapy.
Explanation:
Fluid volume deficit, or dehydration, occurs when the body loses more fluids than it takes in. The nurse must assess several factors that could put clients at risk for this condition, such as their medical history, current treatment, and hydration status.
Client A: The client who is NPO (nothing by mouth) since midnight for an endoscopy may be at risk for fluid volume deficit, but this risk is generally short-term. The NPO status is necessary for the procedure, and fluids can be resumed post-procedure, so while there is a risk, it is not as significant as in the other cases.
Client B: This client with heart failure is receiving diuretic therapy, which is a strong predictor of fluid volume deficit. Diuretics increase urine output to reduce fluid overload in heart failure patients, but they also lead to excessive fluid loss. If the client does not compensate for this loss through adequate fluid intake, they are highly susceptible to dehydration. The nature of diuretics, especially loop diuretics, can lead to significant electrolyte imbalances and dehydration, exacerbating their heart condition.
Client C: The client with gastroenteritis who is receiving oral fluids is at risk for fluid volume deficit due to potential fluid loss through vomiting and diarrhea. However, their oral fluid intake helps mitigate this risk, making them less at risk compared to the client on diuretics.
Client D: The client with end-stage kidney disease undergoing dialysis may face fluid volume changes; however, dialysis typically removes excess fluid rather than causing deficits. Their fluid status is closely monitored and managed by the healthcare team during the dialysis process.
In summary, the client receiving diuretic therapy is at the highest risk for fluid volume deficit due to the increased urinary output and potential inability to adequately replace lost fluids.