Question: A client is admitted with 50% of the body surface area burned after an industrial explosion and fire. The client’s serum albumin is 1.5 g/dL, the hematocrit is 30%, the urine specific gravity is 1.025, and the serum globulin is 3 g/dL. When evaluating the client’s response to fluid replace¬ment, the nurse should prepare to administer a colloid when the:
1. Globulin is 3 g/dL
2. Albumin is below 2 g/dL
3. Hematocrit is below 32%
4. Urine specific gravity is 1.018
Rationale: Administration of a colloid is indicated when the serum albumin decreases below 2 g/dL; then, albumin must be administered to increase the level to the expected range of 3.5 to 5.5 g/dL; this increases the oncotic pressure and prevents the shift of fluid out of the intravascular compartment. A globulin of 3 g/dL is within the expected parameters of 2.3 to 3.4 g/dL. A hematocrit level of 32% is low and indicates overhydration; administration of a colloid will increase this problem. Urine specific gravity is within the expected limits of 1.010 to 1.030.
Clinical Area: Medical Surgical Nursing
Client Need: Pharmacological and Parenteral Therapies
Cognitive Level: Analysis
Nursing Process: Planning
This week’s NCLEX exam practice question came from:
Nugent: Mosby's Review Questions for the NCLEX-RN Exam, 7th Edition, Chapter 2, Page 191, Question 1
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