A nurse is reviewing the medical record of a client. These are the medical reports; Hypoactive bowel sounds upon auscultation, abdomen soft, not distended on palpation and urinary output of 130mL/4hr. Which of the following findings should the nurse report to the provider?
A.
Urine specific gravity
B.
Prealbumin
C.
Temperature
D.
Bowel sounds
The Correct Answer and Explanation is:
The correct answer is A. Urine specific gravity.
Explanation:
The nurse is assessing a client with hypoactive bowel sounds, a soft and non-distended abdomen, and urinary output of 130 mL in 4 hours. While several aspects of this situation are important, the urinary output is notably low. A normal urine output is typically around 30 mL/hour, so over a 4-hour period, the output should ideally be about 120 mL or more. In this case, the output is just slightly above this threshold, which might indicate early signs of dehydration or compromised renal function. Therefore, the nurse should focus on assessing hydration status and kidney function. One important diagnostic measure related to these concerns is urine specific gravity.
Urine specific gravity measures the concentration of solutes in urine and can give insight into the client’s hydration status and kidney function. A high urine specific gravity (above 1.030) can suggest dehydration, as the kidneys are conserving water and producing more concentrated urine. A low specific gravity (below 1.005) might indicate overhydration or a condition in which the kidneys are unable to concentrate urine, such as diabetes insipidus.
In this scenario, hypoactive bowel sounds may suggest decreased gastrointestinal motility, which can be associated with dehydration or electrolyte imbalances. Dehydration can result in reduced renal perfusion, leading to low urine output and concentrated urine. By reporting the urine specific gravity, the nurse can provide the provider with valuable information about the client’s hydration status and guide further interventions, such as fluid administration.
The other options, while important in different contexts, do not directly address the current concerns:
- B. Prealbumin: This is a marker for nutritional status, but there is no indication of nutritional deficiencies in this case.
- C. Temperature: While temperature is important for assessing infection or inflammation, there is no mention of fever or signs of infection here.
- D. Bowel sounds: Hypoactive bowel sounds can indicate decreased gastrointestinal motility, but in this situation, the most urgent concern is the urinary output and possible dehydration.
Thus, urine specific gravity is the most relevant finding that the nurse should report to the provider.