A patient has underlying cardiac disease and requires careful ...

[awywial]

A patient has underlying cardiac disease and requires careful monitoring of his fluid balance. He also has a draining wound. Which of the following methods for evaluating his wound drainage would be most appropriate for assessing fluid loss?
 
  a. Draw a circle around the area of drainage on a dressing.
  b. Classify drainage as less or more than the previous drainage.
  c. Weigh the patient at the same time each day on the same scale.
  d. Weigh dressings before they are applied and after they are removed.

Question 2

At a first aid station on a marathon route, a patient after the race complains of headache, muscle cramps, weakness, nausea, and confusion. Which statement made by the patient might explain these symptoms?
 
  a. I was really thirsty after the race. I drank several large bottles of water.
  b. I perspired quite a bit during the race so I drank sports drinks when I finished.
  c. I take steroids regularly and did not stop taking them for the race.
  d. I am diabetic and checked my blood sugar after the race. It was normal.

[Fayaz00962]

Answer to Question 1

D
By weighing the dressing before it is applied and after it is removed, the nurse can accurately determine the amount of drainage. Weighing the patient daily would evaluate his overall fluid balance but is not sensitive to fluid loss through the wound. Marking a circle around the wound is useful for determining the extent of drainage seeping out of a wound but it does not provide information on how much fluid is draining.

Answer to Question 2

A
Excess intake of hypotonic solutions (e.g., several large bottles of water) will result in hyponatremia, the symptoms described by this patient. Sports drinks contain electrolytes lost through perspiration, so this would not explain the patient's symptoms, indicating hyponatremia. Steroid administration can result in hypokalemia, but the patient's symptoms do not match the symptoms of hypokalemia, so this is not a good explanation. The statement about diabetes does not provide information relevant to the patient's symptoms or to the situation.

[awywial]

Excellent

[peter]

Gracias!