Question

A client diagnosed with pyelonephritis and possible septicemia has had five urinary tract infections over the past 2 years. He's fatigued from lack of sleep; urinates frequently, even during the night; and has lost weight recently. Tests reveal the following: sodium level 152 mEq/L, osmolarity 340 mOsm/L, glucose level 125 mg/dl (6.9 mmol/L), and potassium level 3.8 mEq/L (3.8 mmol/L). Which nursing diagnosis is most appropriate for this client?

A. Deficient fluid volume related to inability to conserve water.
B. Imbalanced nutrition: Less than body requirements related to hypermetabolic state.
C. Deficient fluid volume related to osmotic diuresis induced by hypernatremia.
D. Imbalanced nutrition: Less than body requirements related to catabolic effects of insulin deficiency.

Answer 1

The most appropriate nursing diagnosis for the client with pyelonephritis and possible septicemia, who has had five urinary tract infections over the past 2 years and presents with symptoms of fatigue from lack of sleep, frequent urination, weight loss, and abnormal test results, is Deficient fluid volume related to osmotic diuresis induced by hypernatremia.

Step-by-step explanation:

The most appropriate nursing diagnosis for the client with pyelonephritis and possible septicemia, who has had five urinary tract infections over the past 2 years and presents with symptoms of fatigue from lack of sleep, frequent urination, weight loss, and abnormal test results, is Deficient fluid volume related to osmotic diuresis induced by hypernatremia. The client's high sodium level, osmolarity, glucose level, and potassium level are indicative of fluid imbalance, and the symptoms are consistent with dehydration caused by the osmotic diuresis induced by hypernatremia. This diagnosis addresses the underlying fluid imbalance and its effect on the client's health.