Which of the following would alert the nurse
to suspect that a neonate delivered at 34 weeks’ gestation
who is currently in an isolette with humidifi
ed oxygen and receiving intravenous fl uids has
developed overhydration?
■ 1. Hypernatremia.
■ 2. Polycythemia.
■ 3. Hypoproteinemia.
■ 4. Increased urine specifi c gravity.
-
Decreased protein or hypoproteinemia is
a sign of overhydration, which can lead to patent
ductus arteriosus or congestive heart failure. Bulging
fontanels, decreased serum sodium, decreased urine
specifi c gravity, and decreased hematocrit are other
signs of overhydration. Hypernatremia (increased
serum sodium concentration) or increased urine
specifi c gravity would suggest dehydration, not
overhydration. Polycythemia evidenced by an
elevated hematocrit would suggest hypoxia or
congenital heart disorder.