Jessie weighed 210 pounds on admission to the hospital. After 2 days of diuretic therapy, Jessie weighs 205.5 pounds. The nurse could estimate the amount of fluid Jessie has lost:
A. 0.3 L
B. 1.5 L
C. 2.0 L
D. 3.5 L
Correct Answer: C. 2.0 L
One liter of fluid approximately weighs 2.2 pounds. A 4.5-pound weight loss equals to approximately 2L. Diuresis is necessary for a variety of non-edematous and edematous conditions, which require clearing out excess water when the body abnormally sequesters fluid in third space in the form of edema.
Option A: Option A has a very low amount of fluid loss and is incompatible with the weight that the client has lost. Diuretics are drugs that pharmacologically tilt the renal fluid regulation in favor of excretion of water and electrolytes. Thus, diuretics are substances that increase the production and volume of urine. This class of drugs achieves this objective primarily by suppressing receptors that aid in reabsorption of Na+, the most abundant extracellular cation, from the renal tubules, thereby increasing the osmolality of the renal tubules and consequently suppressing water reabsorption.
Option B: 1.5 L is not an accurate amount of fluid loss based on the client’s weight loss. The most common adverse effect for any diuretic is mild hypovolemia, which can lead to transient dehydration and increased thirst. When there is an over-treatment with a diuretic, this could lead to severe hypovolemia, causing hypotension, dizziness, and syncope.
Option D: 3.5 L is more than the amount of fluid loss based on the client’s amount of weight loss. Diuretic treatment calls for careful assessment of extracellular fluid volume, urine output, electrolyte levels in plasma and urine, body weight, acid-base status, serum glucose, and BP regularly with particular emphasis on patients with cardiovascular, hepatic, renal, or metabolic disorders and in elderly individuals.