NCLEX Question.

[andrewprincesspeach]

Which of these clients should the nurse see first for possibly life threatening fluid volume deficit.

1. 88yr old with a fractured femur scheduled for surgery.

2. 65 yr old recently diagnosed with congestive heart failure.

3. 50 yr old with second degree burns on angles and feet.

4. 20 yr old with 5 year history of type 1 diabetes mellitus.

[TheSquire, DNP, APRN, NP]

5. Don't come here asking us to do your hw for you.

[mRpeNa]

i would say 3 because of the burns...

[kcochrane]

I would have to say #1. Even though he is scheduled for surgery, femur fractures could have bleeding from the femoral artery if it is damaged.

#3 would be on my list next.

That's my first reaction.

[andrewprincesspeach]

This question is not for my Homework assignment in any way. My apologies.. Right now i am studying Fluid Volume Imbalances + Acid Base imbalances and electrolytes. And this was one of the questions that i could not get.

[kcochrane]

The only reason I am hesitant to pick #3 is the size of the burn and the degree. I believe they start IV fluid for more than 15% of the body burned. But don't quote me. Have to run out for an errand, but will look that up when I get back.

But even in a close femur fx, you could lose 1-2 L of blood. For a 88 year old, that could be bad.

[mRpeNa]

well i change my answer...lol...its second degree burns which is blistering..i would change it to #1...

[AggieNurse99, BSN, RN]

Why is the 20 year old in the hospital? A pt with DKA would be the first I'd go to in this group, but it is not clear per the wording.

[andrewprincesspeach]

At first I said 3, due to the burns. I didnt even put it together that the Femoral Artery may be severed.

[kcochrane]

• general indications for fluid resuscitation:
  

  
  

  • 
    
    • 1. burns > 20% of bsa with adults
      
    • 2. burns > 10% of bsa with children
      
    • 3. age >65 or

each leg is 9%, but i have no idea what a foot or ankle would be.

[NSALVADORE]

My vote is for #1...

[lady_godiva,RN]

I would choose 1, since the patient is 88 year old, older people are risk for fluid deficit due to decreased fluid intake and at the same time he is going to have an operation on the fractured femur so she is at risk for life threatening fluid volume deficit from loss of blood during the operation..