What is your answer to this question?

[Laurs14]

How would you answer this question? I got it wrong!

Mr. A was admitted to the hospital after feeling nausea and vomiting for 4 days, what is the most accurate way to determine the extent of his fluid loss?

1) Assess skin turgor

2) Weigh patient daily

[Isitpossible, LPN, LVN]

i would think weigh daily..what did you think?

[CoffeemateCNA]

I think the key word here is *accurate.*

Assessing turgor is fairly imprecise. Decreased turgor does not occur until later stages of dehydration, and can have misleading results in some age groups.

Weighing is objective and would seem to be the most accurate.

Which did you pick and what was your rationale?

[BluegrassRN]

You aren't going to know his baseline weight. As an ongoing measure, measuring weight is much more accurate. If he is a new admit or just presenting, you'll have to go with turgor, I think.

[Laurs14]

I chose skin turgor and it was wrong. My rationale is that the question implies that the patient lost fluid prior to coming into the hospital therefore how would daily weighing help you to "deterrmine the extent of his fluild loss" when he lost the fluid prior to coming into the hospital?

Also, wouldnt' 4 days of fluid loss make you want to check fluid loss immediately rather than comparing daily weights?

[CoffeemateCNA]

I think the question was very poorly worded. Too ambiguous.

I wonder if your instructor added the background information in the first part just to throw students off, and really only wanted the question answered from looking at the second half of the question? Who knows. . .

[believeallispossible]

majority of nursing questions are poorly worded.

[suzers26]

Whenever you need to gather specific information unknown to you it is always best to ask the patient/family, depending on what the case may be, because most have a pretty good idea on what is 'normal' baseline for theselves on basic things. Gathering information on them, from them is considered objective, just as if you were assessing pain using pain scales & descriptions from the patient. We don't just say they are not in pain because we can't scientifically measure it, we ask them about it in detail and consider it objective of what they feel. And, of course you will continue to weigh them daily because that will tell you if they are still losing fluid or if they are gaining it back evidenced by return to their normal stated weight.

So to compare his current wt. to what he states he weighed prior to illness would be more accurate than turgor. Weight is always the best way to measure fluid imbalances no matter what the question states. We've had multiple questions similar to this on our exams and our instructor has drilled this point home with my class to the point that if anyone ever gets it wrong again there may be consequences....lol.

[morte, LPN, LVN]

lol, if you think a majority of your patients are honest about their weight, i have a bridge in brooklyn you might find attractive.....

[suzers26]

lol, if you think a majority of your patients are honest about their weight, i have a bridge in brooklyn you might find attractive.....

I never said they'd be honest...what I said is that's considered just as objective is doing a pain assessment. And that is what is expected for an answer on these tests. I'm sure many exaggerate pain too, but we have no other way to measure it.