Question

A nurse is assessing a client who received an IV fluid bolus for dehydration. Which of the following findings should the nurse identify as an indication of fluid volume excess?

1) Increased urine output
2) Decreased blood pressure
3) Weight loss
4) Edema

Answer 1

The nurse should identify edema as an indicator of fluid volume excess post IV fluid bolus for dehydration.

Step-by-step explanation:

A nurse assessing a client for indications of fluid volume excess following an IV fluid bolus for dehydration should be observant of signs such as edema. Edema is the accumulation of excess water in the tissues and is a common symptom of fluid volume excess. When assessing for edema, one would look for swelling of the subcutaneous tissues, enlarged limbs, tight skin, and a persistence of an indentation when pressure is applied (pitting). Therefore, the correct answer is option 4) Edema, which signifies that there may be a fluid overload present.