Question

The nurse is obtaining a history of an 80-year-old client. Which statement made by the client might indicate a possible fluid and electrolyte imbalance? A. "My skin is always so dry." B. "I often use a laxative for constipation." C. "I have always liked to drink a lot of ice tea." D. "I sometimes have a problem with dribbling urine."

Short answer

A. My skin is always so dry. B. I often use a laxative for constipation. C. I have always liked to drink a lot of ice tea. D. I sometimes have a problem with dribbling urine. Answer: B. I often use a laxative for constipation.

Step-by-step solution

Evaluate statement A

Statement A says, "My skin is always so dry." Dry skin could be a result of many factors, such as aging, environmental factors, or dehydration. In this case, it doesn't necessarily indicate a fluid and electrolyte imbalance.

Evaluate statement B

Statement B says, "I often use a laxative for constipation." Frequent use of laxatives can cause fluid and electrolyte imbalances in the body, as they can lead to dehydration and loss of essential electrolytes, such as potassium and sodium.

Evaluate statement C

Statement C says, "I have always liked to drink a lot of ice tea." Drinking a lot of ice tea could lead to excessive fluid intake, but it does not necessarily result in fluid and electrolyte imbalances. Although excessive consumption of caffeinated drinks might have an effect on fluid balance, it is not a definite indicator in this context.

Evaluate statement D

Statement D says, "I sometimes have a problem with dribbling urine." This statement might indicate a urinary issue like incontinence, but it doesn't necessarily suggest a fluid and electrolyte imbalance.

Choose the best answer

Based on the evaluation of all the statements, statement B "I often use a laxative for constipation" is the one that might indicate a possible fluid and electrolyte imbalance, since frequent use of laxatives can lead to dehydration and loss of essential electrolytes. Therefore, the correct answer is B.

Key concepts

Nursing Assessment

Nursing assessment is a crucial part of understanding and evaluating a patient's health status. It involves a holistic approach to gathering information about a patient's physical, psychological, and social status. In the context of fluid and electrolyte balance, a nursing assessment helps identify potential imbalances that could significantly affect health. Nurses use various techniques such as observation, history taking, and physical examination to gather necessary information.

Key components of a nursing assessment include:

• Observing the patient's skin condition and hydration levels. Dry skin can be a sign of dehydration.
• Monitoring fluid intake and output to detect any discrepancies that might suggest imbalances.
• Assessing electrolyte levels through blood tests.
• Evaluating bowel habits to understand the role of medication like laxatives.

Identifying the potential issues early can lead to prompt intervention and management, preventing more severe complications.

Geriatric Nursing

Geriatric nursing focuses on the care of older adults, who often have complex health needs due to aging processes and chronic conditions. Fluid and electrolyte balance is particularly crucial in geriatric populations because:

• Aging affects kidney function, reducing the body's ability to conserve water and electrolytes.
• Decreased thirst sensation in elders leads to a higher risk of dehydration.
• Older adults often take multiple medications that can influence fluid and electrolyte levels.

The goal of geriatric nursing is to maintain and enhance the quality of life for elderly patients. This includes understanding their unique physiological changes and making adjustments in nursing care plans to address such issues. Awareness of fluid and electrolyte balance is essential to accomplish these goals and support the well-being of geriatric patients.

Patient History Evaluation

Evaluating a patient's history is a key element in detecting potential fluid and electrolyte imbalances. It involves gathering detailed information about the patient's lifestyle, medical history, and current symptoms. This information helps identify risk factors and plan effective interventions. For instance, frequent use of laxatives, as mentioned in the exercise, signals a need for monitoring due to the potential for dehydration and electrolyte loss.

When evaluating a patient's history, consider asking about:

• Dietary habits to identify intake of fluids and potential diuretics like caffeine.
• Medication usage, highlighting drugs that affect fluid and electrolyte balance such as diuretics or laxatives.
• Previous medical conditions, especially those impacting renal or cardiovascular function.

This comprehensive approach ensures that care strategies are tailored to the patient's specific needs and health status.

NCLEX-PN Exam Preparation

Preparing for the NCLEX-PN exam involves understanding the principles of nursing care across various topics, including fluid and electrolyte imbalances. The NCLEX-PN tests knowledge and application of nursing care processes in different scenarios.

Here are some tips to better prepare for questions related to fluid and electrolyte imbalances:

• Understand the signs and symptoms of major imbalances such as dehydration, hyponatremia, and hyperkalemia.
• Familiarize yourself with the effects of medications that can cause fluid shifts.
• Practice interpreting patient statements that suggest problems with fluid balance, like the frequent use of laxatives.
• Utilize practice questions to reinforce your understanding and improve your critical thinking skills.

Thorough preparation will enable you to confidently address these questions, ensuring a better chance of success on the exam.