Question

A nurse is planning to monitor a client for dehydration following several episodes of vomiting and an increase in the clients temperature. Which of the following findings should the nurse identify as an indication that the client is dehydrated?

A. Urine specific gravity 1.034 Rationale: The client's urine specific gravity is elevated, reflecting concentrated urine, which is a manifestation of dehydration.
B. Bounding pulse Rationale:A client who has dehydration would have a weak pulse.
C. BP 146/94 mm Hg Rationale: A client who has dehydration would have hypotension.
D. Distended neck veins Rationale: Neck vein distention is a manifestation of fluid-volume excess, not dehydration.

Answer 1

An elevated urine specific gravity of 1.034 is an indication of dehydration which reflects concentrated urine due to the body conserving water. Other symptoms like a weak pulse and hypotension, not bounding pulse or hypertension, are also indicative of dehydration. Proper diagnosis using specific gravity and other symptoms ensure accurate treatment.

Step-by-step explanation:

A nurse planning to monitor a client for dehydration should be aware of various indicators. One such indicator is an elevated urine specific gravity, which reflects concentrated urine due to the body's conservation of water under dehydrated conditions. Urine specific gravity values higher than the normal range (typically 1.010 to 1.025) suggest dehydration, as the kidneys are reabsorbing more water to compensate for water loss, with a value of 1.034 indicating significant concentration. In contrast, signs such as a bounding pulse, hypertension, and distended neck veins suggest fluid volume excess rather than dehydration. A dehydrated client is more likely to present symptoms like a weak pulse, hypotension, and a lack of neck vein distention due to reduced blood volume.

Dehydration can be caused by a variety of conditions, including prolonged vomiting, diarrhea, and insufficient fluid intake. It leads to reduced cardiac output and increased pulse rate, as well as a general feeling of exhaustion. The nurse must be vigilant in monitoring for these classic symptoms and use diagnostics like urine specific gravity or osmolality tests to confirm their assessment. These measures help ensure accurate diagnosis and timely intervention.