The nurse has established an objective for a client who has been unable to void. The client's intake will be at least 1000 mL between 7:00 A.M. and 3:30 P.M. Which one of the following in-dicates successful feedback from the client?
a. The client voids at least 1000 mL during the shift.
b. The client verbalizes abdominal comfort without pressure.
c. The client has adequate intake and output.
d. The client drinks 240 mL of fluid five or six times during the shift.
D
The nurse evaluates success by observing the client's performance of each expected behaviour. Feedback indicating success in this situation is the client drinking 240 mL of fluid five or six times during the shift. This would total a fluid intake of 1200 to 1440 mL, meeting the objective of at least 1000 mL during the designated period.
Voiding at least 1000 mL during the shift is not the objective. The objective is to have the client drink at least 1000 mL during the designated period.
Verbalizing abdominal comfort without pressure is not an evaluation of the objective regarding specific fluid intake.
Having adequate intake and output is not accurate feedback indicating success. The term ade-quate is not quantified.
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