A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit?
A.
The client who has end-stage renal failure and is scheduled for dialysis today.
B.
The client who has been NPO since midnight for endoscopy.
C.
The client who has left-sided heart failure and has a brain natriuretic peptide (BNP) level of 600 pg/mL.
D.
The client who has gastroenteritis and is febrile.
The Correct answer and Explanation is:
The correct answer is B. The client who has been NPO since midnight for endoscopy.
Explanation:
Fluid volume deficit occurs when there is a loss of body fluids, leading to dehydration and electrolyte imbalances. In this scenario, we need to assess each client to determine who is at the highest risk for this condition.
A. The client who has end-stage renal failure and is scheduled for dialysis today.
This client is not necessarily at risk for fluid volume deficit because dialysis is a treatment designed to remove excess fluid. The dialysis process itself typically involves fluid removal; however, the client may have been carefully monitored for fluid balance leading up to this procedure.
B. The client who has been NPO since midnight for endoscopy.
This client is at significant risk for fluid volume deficit. Being NPO (nothing by mouth) means the client has not had any intake of fluids for an extended period, especially if the endoscopy is scheduled for the morning after midnight. This lack of fluid intake, combined with any potential pre-existing conditions (such as nausea, vomiting, or other gastrointestinal issues), can quickly lead to dehydration.
C. The client who has left-sided heart failure and has a BNP level of 600 pg/mL.
While this client has a BNP level indicative of heart failure, which can lead to fluid overload rather than deficit, the risk for fluid volume deficit is not as pronounced. In heart failure, the body often retains fluid, increasing the risk of fluid overload rather than deficit.
D. The client who has gastroenteritis and is febrile.
This client may be losing fluids due to diarrhea or vomiting associated with gastroenteritis. However, the presence of fever can also stimulate fluid retention as part of the body’s response to infection. While they are at risk, they have not necessarily been without fluid intake.
In conclusion, the client who is NPO since midnight (Option B) is at the highest risk for fluid volume deficit due to a complete lack of oral fluid intake for an extended period, which can lead to dehydration.