For a male client with hyperglycemia, which assessment finding best supports a nursing diagnosis of Deficient fluid volume?
- a- Cool, clammy skin.
- b- Distended neck veins.
- c- Increased urine osmolarity.
- d- Decreased serum sodium level.
Answer C.
In hyperglycemia, urine osmolarity (the measurement of dissolved particles in the urine) increases as glucose particles move into the urine.
The client experiences glucosuria and polyuria, losing body fluids and experiencing fluid volume deficit.
Cool, clammy skin; distended neck veins; and a decreased serum sodium level are signs of fluid volume excess, the opposite imbalance. Urinary ammonia is the measurement of urine concentration. Large values indicate concentrated urine, ie, high concentration, while small values refer to diluted urine.
urine osmolarity:
Increased urine osmolarity is the best assessment finding that supports a nursing diagnosis of Deficient fluid volume in a male client with hyperglycemia.
Hyperglycemia, or high blood sugar, can cause the body to lose fluids through urine. This happens because the kidneys try to excrete the excess sugar by filtering it out of the blood. The more sugar in the blood, the more fluids the kidneys will excrete.
Increased urine osmolarity is a measure of the concentration of particles in urine. When a person is dehydrated, their urine will become more concentrated, meaning that it will have a higher osmolarity.
Other assessment findings elements:
Other assessment findings that may be present in a client with Deficient fluid volume include:
- Dry skin and mucous membranes.
- Decreased skin turgor.
- Decreased urine output.
- Increased respiratory rate.
- Tachycardia (rapid heart rate).
- Hypotension (low blood pressure).
If a nurse suspects that a client has Deficient fluid volume, they will need to assess the client's hydration status and vital signs. The nurse will also need to monitor the client's urine output and laboratory values, such as blood urea nitrogen (BUN) and creatinine.
Treatment for Deficient fluid volume typically involves intravenous fluids. The goal of treatment is to replace the fluids that the body has lost and to restore normal hydration status.
Nursing interventions for Deficient fluid volume include:
- Administering intravenous fluids as ordered.
- Monitoring the client's hydration status and vital signs.
- Monitoring the client's urine output and laboratory values.
- Providing the client with oral fluids, if tolerated.
- Educating the client on the importance of staying hydrated.
Evaluation of nursing interventions for Deficient fluid volume:
- The client's hydration status will improve.
- The client's vital signs will return to normal.
- The client's urine output will increase.
- The client's laboratory values will return to normal.
Conclusion:
Increased urine osmolarity is the best assessment finding that supports a nursing diagnosis of Deficient fluid volume in a male client with hyperglycemia. Nurses should monitor the client's hydration status and vital signs, and provide the client with intravenous fluids as ordered.
