Fluid Imbalance

[sarajane_10]

Question on an exam:

When evaluating the response to treatment for a patient with a fluid imbalance, the best assessment indicator to include is:

A.Hourly urine output

B. Daily weights

[nurseprnRN, BSN, RN]

remember that "treatment" isn't always in the hospital; the original question did not say that it was. indeed, the vast majority of "treatment" occurs outside hospital walls. if a patient's daily diuretic dose or other actions are occurring at home, the only monitoring (which is the way you assess "response to treatment") that can occur there is weight change. again, if this is a school question, it's tied to the nclex questions, and i promise you "urine output" isn't what they want to hear. one more thing: there are people who don't have urine outputs (anuria), and their fluid balance is still of concern.

daily weight

daily weight

daily weight

[CBsMommy]

The answer is daily weight. I got this question wrong in my fundamentals class and will never forget it.

[Unknown member]

my vote is daily weights.... we were taught that weighing our patients is the single best method for monitoring fluid status.

remember, for every 1000 mL of fluid the body retains, there is an increase of 1 kg in body weight

also, we must look at what the question is asking. it says " best indicator " which is definitely daily weights. someone argued it's not a "response to treatment" however, weight loss/gain can certainly be in response to treatment so i don't quite understand your argument. and someone else argued urine output is a "faster" way to monitor, but again the question does not ask this.

original poster, can you please share the correct answer?

[link51411]

not a good queston. it depends on the pt.

lets just say for example the pt had a pit tumor removed. they may dump fluid and be dehydrated which is why you check NA and hr intake and output. however, the other is true also. if your in renal failure you know your not going to get anything out so you look at daily weights and other lab work.

tell me if you think im off with this one.

[Unknown member]

I hate NCLEX-style questions because I always feel it depends on individual circumstances and I'm always thinking "well I need the patients history, meds, VS, to answer this ?" but in reality, you just have to go with the *best* answer based on the information given..... OOO The joys of NCLEX

of course, we know in the real world, as a nurse we'd be monitoring both I&O AND daily weights AND many other things in order to properly care for this patient

[sarajane_10]

I will when I get my exam back! Thanks Everyone