A nurse in the medical-surgical unit has a newly admitted patient who is oliguric; the acute care nurse practitioner orders a fluid challenge of 100 to 200 mL of normal saline solution over 15 minutes. The nurse is aware this intervention will help:

Question

A) Distinguish hyponatremia from hypernatremia
B) Evaluate pituitary gland function
C) Distinguish reduced renal blood flow from decreased renal function
D) Provide an effective treatment for hypertension-induced oliguria

Answer 1

Ans: C
Chapter: 14
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 4
Patient Needs: D-2
Feedback: If a patient is not excreting enough urine, the health care provider needs to determine whether the depressed renal function is the result of reduced renal blood flow, which is a fluid Volume deficit (FVD) or prerenal azotemia, or acute tubular necrosis that results in necrosis or cellular death from prolonged FVD. A typical example of a fluid challenge involves administering 100 to 200 mL of normal saline solution over 15 minutes. The response by a patient with FVD but normal renal function is increased urine output and increased blood pressure. Option A is incorrect; laboratory exams are needed to distinguish hyponatremia from hypernatremia. Option B is incorrect; a fluid challenge is not used to evaluate pituitary gland function. Option D is incorrect; a fluid challenge may give you information regarding hypertension-induced oliguria, but it is not an effective treatment.