Difficulty: Medium
Average Score: 90%
Simulated
A nurse is assessing a client who has heart failure and is taking furosemide. Which of the following findings should indicate to the nurse that the client is experiencing fluid volume deficit?
Correct answer
A
Rationale
Correct Answer: A - Elevated hematocrit level
Rationale: Furosemide is a loop diuretic that promotes diuresis, leading to fluid loss. As a result of fluid volume deficit, there will be a concentration of red blood cells in the blood, causing an elevated hematocrit level. This occurs because with less fluid in the bloodstream, the ratio of red blood cells to plasma increases. Elevated hematocrit is a common indicator of dehydration or fluid volume deficit.
Summary of other choices:
B: Shortness of breath - This is a symptom of fluid volume overload, not deficit.
C: Distended neck veins - This is a sign of fluid volume overload, not deficit.
D: Weight gain - This is a sign of fluid volume overload, not deficit.
Rationale: Furosemide is a loop diuretic that promotes diuresis, leading to fluid loss. As a result of fluid volume deficit, there will be a concentration of red blood cells in the blood, causing an elevated hematocrit level. This occurs because with less fluid in the bloodstream, the ratio of red blood cells to plasma increases. Elevated hematocrit is a common indicator of dehydration or fluid volume deficit.
Summary of other choices:
B: Shortness of breath - This is a symptom of fluid volume overload, not deficit.
C: Distended neck veins - This is a sign of fluid volume overload, not deficit.
D: Weight gain - This is a sign of fluid volume overload, not deficit.