A nurse is reviewing the laboratory results of a client who has fluid volume deficit. The nurse would expect which of the following findings?
A.
Sodium 155 mEq/L
B.
Hematocrit 44%
C.
Urine specific gravity 1.035
D.
BUN 19 mg/dL
The correct answer and Explanation is :
In a client with fluid volume deficit, the most likely laboratory findings include elevated sodium levels, increased hematocrit, elevated urine specific gravity, and an increased blood urea nitrogen (BUN) level. Here’s a breakdown of each finding and its relevance:
A. Sodium 155 mEq/L: This value is higher than the normal range (135-145 mEq/L). Fluid volume deficit often leads to elevated sodium levels due to hemoconcentration. As the body loses fluid, the sodium concentration increases relative to the decreased volume.
B. Hematocrit 44%: Hematocrit measures the proportion of blood volume that is occupied by red blood cells. A normal hematocrit level ranges from 38-50% for adults. In cases of fluid volume deficit, hematocrit levels may rise because there is less plasma volume in the blood, leading to a relative increase in hematocrit.
C. Urine specific gravity 1.035: This is an elevated urine specific gravity (normal range is 1.005 to 1.030). High specific gravity indicates that the urine is concentrated, which is a common response to fluid volume deficit as the kidneys attempt to retain water and concentrate the urine to compensate for the lack of fluid.
D. BUN 19 mg/dL: BUN levels can be elevated in fluid volume deficit, but 19 mg/dL is within the upper normal range (7-20 mg/dL). While an elevated BUN can indicate dehydration, it’s not as specific as the other findings for fluid volume deficit.
Correct Answer: C. Urine specific gravity 1.035
Explanation: Urine specific gravity is a direct indicator of the kidneys’ ability to concentrate urine. In fluid volume deficit, the kidneys conserve water, leading to more concentrated urine and thus a higher specific gravity. Elevated sodium and hematocrit levels also support the diagnosis, but the specific gravity directly reflects the kidneys’ response to fluid loss. While BUN can be elevated due to dehydration, it’s not as directly indicative of fluid volume status as urine specific gravity. Therefore, urine specific gravity of 1.035 is the most specific finding for a fluid volume deficit.