Final answer:
A nurse should expect a decreased urine specific gravity and possibly a decreased sodium level in the lab report of a client with fluid volume excess, reflecting a condition of hypervolemia and diluted blood constituents.
Step-by-step explanation:
A nurse reviewing the laboratory report of a client with fluid volume excess should expect to see certain lab value alterations. In the context of hypervolemia, which is due to the retention of water and sodium, one would not expect an increased hematocrit or BUN, as these would typically increase with dehydration. Instead, the nurse can anticipate a decreased urine specific gravity because the kidneys may be unable to concentrate urine sufficiently due to the excess fluid. Additionally, there may be a decreased sodium concentration because of dilution caused by the retained fluids.
It is noteworthy that while conditions like vomiting or diarrhea can lead to elevated blood urea levels due to dehydration, hypervolemia is characterized by increased blood volume and pressure, not by decreased blood volume that raises BUN. Hormonal imbalances, such as decreased aldosterone secretion, could also contribute to a variable presentation of electrolyte and fluid status. An understanding of the underlying causes of hypervolemia, including heart failure, liver cirrhosis, and kidney disease, is crucial in addressing the fluid imbalance and restoring homeostasis.