Answer to Question 1
ANS: A, B, E
Manifestations of fluid overload include increased pulse rate, distended neck veins, increased blood pressure, pale and cool skin, and skeletal muscle weakness.
Answer to Question 2
ANS: D
An older adult with moderate dehydration may experience orthostatic hypotension. The client should dangle on the bedside before ambulating. Although dehydration in an older adult may cause confusion, speaking quietly will not help the client remain calm or decrease confusion. Assessing the client's urine may assist with the diagnosis of dehydration but would not prevent injury. Clients are encouraged to drink fluids, but 1 liter of fluid each shift for an older adult may cause respiratory distress and symptoms of fluid overload, especially if the client has heart failure or renal insufficiency.
Critical thinking involves analysis in which the nurse examines patient data available from a variet
Client on IV patient-controlled analgesia (PCA).
Pericardial effusion: A, normal pericardial sac; B, pericardial sac with excess fluid possibly causi
Nurse using a stethoscope
Nursing Care Plan Process: Client with High Blood Lipid Levels
Hyperbaric Oxygen Chamber Used in the Treatment of Decompression Illness