Question

A nurse on a medical-surgical unit is reviewing the medical record of an older adult client who is receiving IV fluid therapy. Which of the following client information should indicate to the nurse that the client requires re-evaluation of the IV therapy prescription?

a) Blood pressure within normal range.
b) Urine output below baseline.
c) Heart rate of 80 beats per minute.
d) Respiratory rate of 18 breaths per minute.

Answer 1

A urine output below the client's baseline indicates the need for re-evaluation of IV fluid therapy in an older adult, as it can signal complications such as fluid overload or renal issues.

Step-by-step explanation:

A nurse reviewing the medical record of an older adult client receiving IV fluid therapy should be alerted that the client may require a re-evaluation of the IV therapy prescription if noting a urine output below baseline. While blood pressure within the normal range, a heart rate of 80 beats per minute, and a respiratory rate of 18 breaths per minute are considered to be within normal limits, urine output below the client's baseline can be indicative of potential complications such as fluid overload, renal insufficiency, or dehydration, especially in older adults. Evaluating the IV fluid therapy in light of decreased urine output is critical to ensure appropriate fluid balance and to prevent further complications.