Question I got wrong on my test!

[Laurs14]

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

[Anne36, LPN]

Im so frustrated reading this thread and Im only in A&P. I had an experience yesterday and asked my Prof a question and he contradicted himself with his response. I still dont know the answer.

[itsmejuli]

when doing nclex style questions get in the habit of finding the key words in the question. doing this will guide you to the correct answer. and don't overanalyze the questions!

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

[latebloomer74, LPN]

"The best indicator of fluid gain or loss is weight" I'll never forget when my instructor said that, especially after most of the class got a similiar question to yours wrong. We learn from our mistakes. That's why I liked the test reviews, very helpful.

[semester1kid]

I would guess weight loss because skin turgor can only tell you that there is a lack of hydration...not how much. And on a day to day basis, changes in your body's weight is affectly mostly by fluid weight. Loss of muscle or fat is generally measured over a longer period of time, whether it's a week, a month or whatever.

[BluegrassRN]

How many patients know exactly how much they weigh every day? How can someone present with a condition and by weighing him you can tell his fluid status? How exactly do you know the baseline? How do you know if their home scale is accurate and calibrated equally to the hospital scale? In the ED and upon admission to the floor, we would go by his labs, mucous membranes, and skin turgor. NOT WEIGHT. If the patient was an inpatient and had been there for a few days, absolutely we would go by daily weight.

Once again, nursing school questions apparently are written to be directly opposite of what real world nursing (and real world critical thinking) is actually like.

[semester1kid]

Well, I still don't see how skin turgor unto itself would give you 'extent' since it's only an general indictor. For me, a skin turgor test that didn't result in good, elastic skin only tells me to look further into this problem...not the end all be all answer to what the problem is.

[semester1kid]

How many patients know exactly how much they weigh every day? How can someone present with a condition and by weighing him you can tell his fluid status? How exactly do you know the baseline? How do you know if their home scale is accurate and calibrated equally to the hospital scale? In the ED and upon admission to the floor, we would go by his labs, mucous membranes, and skin turgor. NOT WEIGHT. If the patient was an inpatient and had been there for a few days, absolutely we would go by daily weight.

Once again, nursing school questions apparently are written to be directly opposite of what real world nursing (and real world critical thinking) is actually like.

Would you do that just for a general diagnosis or can you specify how much fluid loss is occurring by the tests you suggest? I assumed (perhaps wrongly) that the patient was admitted to the hospital and weighing was an intervention. Perhaps you could follow the I/O chart for further elaboration??? But once again, obviously the client would have to be admitted into the hospital for this and they would have to be instructed to ensure all of the 'O's would be evacuated into a container for measurment

[SRK77]

I am thinking skin turgor as well considering you don't have a baseline to go off of. However, if he was admitted during those four days of fluid loss then daily weights would be more accurate along with 24 hour total I & O.

[Nurse SMS, MSN, RN]

I would have answered daily weight. Skin turgor assesses for dehydration but the extent of fluid loss in a nonemergent situation would be via weighing same time of day under same circumstances in same clothing.

[toninurse]

It's daily weights.

One problem I had in school was that I read too much into the question. Don't assume this is an emergency room, or that the patient has any fluid loss problems at present. What did we learn in school? ...that weight loss is the best way to determine fluid loss.

[Ella26, BSN, RN]

I def agree w toninurse, Im an LPN and in nursing school I struggled w those questions and just answering based on what they are looking for. I was always one that would say....well what about this and this, and I had to learn not to read too much into the question. That helped alot on the NCLEX, my instructor told us flat out if u are one that reads too much into the questions you will fail nclex, you have to refocus on what they are actually asking you. simply read the question, decided what they are asking and answer the question dont ask well what if the pt did this beofre coming or whatever. All the info that u need to answer the question is there. And for nclex style questions your supposed to go of what u learned in th books, not ur real life experience thats why people find it so contradicting. But nclex wants to know what u learned in the books, b/c ur not licensed to be out there getting exp obviously b/c ur not a licensed nurse yet. Hope that makes sense

[BluegrassRN]

I hate that "you read too much into the question" comments form instructors. Really? You don't want us to develop critical thinking skills, analyzing all angles? You just want us to look at one little aspect of a situation? Great instruction.