Question I got wrong on my test!

Nursing Students General Students

Published

Mr. A came into the hospital with naseau and vomiting for the past 4 days. What is the most accurate way to determine the extent of his fluid loss?

1) Weight him daily

2) skin turgor

Look for the key words in this question.

The key words are: ...the most accurate way...

A measurement is always "the most accurate way" to find something out.

Therefore the correct answer is: measure the patient's weight loss.

Hope this helps.

Thanks It does help. So the scenario can trick you. You must concentrate on what they are asking. This I will have to remember when it is time for me to take the NCLEX.

;)

Up Vote Up Vote ×

Carreont- this wasn't an nclex question... I put it under the wrong heading!

And yes it does help Arosusa! Thank you!

Up Vote Up Vote ×
Carreont- this wasn't an nclex question... I put it under the wrong heading!

And yes it does help Arosusa! Thank you!

Laurs I understand that it wasn't an nclex question but it's nice to pick through questions even if its not an nclex one to see how I should be interpreting the question. So thanks for sending the question out. I am sure it will help me for the nclex if I can just remember to focus on what they are asking.

Up Vote Up Vote ×
Specializes in Medical and general practice now LTC.

Because this was a school question have moved to the general student nurse discussion forum

Up Vote Up Vote ×

This was a question on one of my tests as well and the answer was actually skin turgor bc hes 4 days with n/v and you don't know his original weight before the vomiting so you can't compare it to now to know his fluid loss.

Up Vote Up Vote ×

exactly- you have nothing to compare it to and it is something you can do ight then, monitoring you would do weight and an initial bed weight at admission- most accurate- think vital signs, labs, urine output-- his is a bad q- I would ask for the teacher to give you ref from the text...

Up Vote Up Vote ×

well skin turgor isn't always very accurate either. the question didn't state the age, but depending on the pts. age it can be rather useless IMO.. elderly pts tent, not r/t dehydration, but just old age and looser skin. that would be my rationale for choosing to weigh, rather than check turgor. but i think one of the pp hit it spot on where the question says MOST ACCURATE. sometimes it's just the simplest things that can throw you off

Up Vote Up Vote ×

You have to have something to compare the daily weight to, and you aren't going to have that at admission, unless the patient knows a recent weight, and even then scales are calibrated differently, etc. You would have to weigh him on the same scale at least twice, 24 hours apart to be able to deduce anything from a daily weight. Skin turgor wouldn't be as accurate as a daily weight, but in the ER that's all you have. The question should be thrown out, IMO, because yes, daily weights are more accurate, but it is not feasible in the scenario you were given.

Up Vote Up Vote ×
Specializes in Emergency Room.

N/V X 4 days is pretty severe. You wouldn't weigh them cause you didn't know what they weighed when they didn't have FVD ( Fluid Volume deficit) So skin turgor and mucous membranes.

Anyone loosing fluid by vomiting or diarrhea is going to get an IV of fluid immediately unless they are CHF ( Congestive heart failure).

Daily weights is to watch there fluid retention. Also urine output is important.

Hope that helps.

Up Vote Up Vote ×
Mr. A came into the hospital with naseau and vomiting for the past 4 days. What is the most accurate way to determine the extent of his fluid loss?

1) Weight him daily

2) skin turgor

Our instructors pound "Daily Weights" into us for assessing fluid status from day one, bless their hearts.

Now if I could only get some of those other ones right.....

Up Vote Up Vote ×
Specializes in Emergency Dept. Trauma. Pediatrics.

It would be daily weights. Skin turger is a sign of dehydration. But when talking about fluid gains and losses daily weights is the what they go off of. Although it think it's a badly worded question. The word extent is bad because the question makes it sound like he just came in, scales are different and the base weight would be subjective. If he has been doing this for 4 days and just came in, you will be treating for the after effect of this.

BUT if they are saying he is a patient and been having this then accurate I&O's and daily weights will be key.

They question isn't exactly clear by making it seem like he is coming in after the 4 days and them needed to know the EXTENT of it.

Just my take on it though.

Up Vote Up Vote ×
Specializes in Emergency Dept. Trauma. Pediatrics.
N/V X 4 days is pretty severe. You wouldn't weigh them cause you didn't know what they weighed when they didn't have FVD ( Fluid Volume deficit) So skin turgor and mucous membranes.

Anyone loosing fluid by vomiting or diarrhea is going to get an IV of fluid immediately unless they are CHF ( Congestive heart failure).

Daily weights is to watch there fluid retention. Also urine output is important.

Hope that helps.

EXACTLY. I guess I should have read through all the responses first, but I need to try and pry myself off of here and go to bed LOL. Anyway, you said it better then I just did. I mean, if they are talking about he just got admitted and what is the best weight to check, it would be getting the baseline, IN the hospital and using the same scale to check daily and do strict I&O but the question is presented poorly IMO.

That's nursing school for you.

I just found out that variable D-Cells are a sign of a REASSURING NST. HMMMMM interesting and completely contradictory of what we were just taught and not ONE nurse on the OB unit agrees with that. But apparently they are according to our exam :|

Up Vote Up Vote ×
+ Add a Comment