Which is the nurse most likely to observe in the client with fluid volume deficit?
1. Hematocrit of 55%
2. High blood pressure
3. Distended neck veins
4. Capillary refill >3 sec.
1
1. The client with fluid volume deficiency has concentrated blood, so serum studies appear more concentrated than it actually is because the normal volume of solvent is low.
2. The client is more likely to be hypotensive with deficient fluid volume because the cardiac filling pressures are lower and the circulating blood volume is low.
3. The nurse expects flat neck veins in the client with fluid volume deficit.
4. Capillary refill is a nonspecific, nonsensitive indicator of peripheral perfusion.
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