Question

A nurse is assessing a client who has fluid volume excess. Which of the following manifestations should the nurse expect?

A) Weak peripheral pulses
B) Increased hematocrit
C) Crackles in the lungs
D) Weight loss

Answer 1

A nurse would expect a client with fluid volume excess to exhibit crackles in the lungs, caused by the popping sound of small airways opening due to excess fluid. This is indicative of pulmonary edema and is a common symptom when fluid accumulates in the lungs, interfering with gas exchange.

Step-by-step explanation:

A nurse assessing a client with fluid volume excess would expect to see several manifestations. The correct answer to the question is C) Crackles in the lungs. This symptom occurs because excess fluid in the alveoli causes a distinctive popping sound when the small airways pop open during inspiration. This is a common feature of conditions like pulmonary edema where fluid accumulates in the lung's air sacs interfering with gas exchange and making it difficult for the client to breathe.

Patient B, who has pulmonary edema, would not exhibit weight loss as a symptom of fluid volume excess. Instead, weight gain is often noted due to the retention of fluid. Other potential manifestations of fluid volume excess include swelling (edema), particularly in the lower extremities, elevated blood pressure due to increased blood volume, and possible alterations in mental status. Further complications can occur in severe cases, such as in Benjamin's case, where the excess fluid compromises oxygenation and can lead to fatal respiratory distress.