From the listed nursing problems, which nursing diagnosis is most appropriate to address fluid overload in ESRD?

• A. Risk for infection.
• B. Fatigue.
• C. Excess fluid volume.
• D. Knowledge deficit.

Answer: (C)

In ESRD, fluid balance is the central issue because the kidneys can’t effectively remove water and sodium, leading to fluid retention. The nursing diagnosis that best addresses this problem is Excess fluid volume, since it directly reflects the imbalance and guides actions to prevent complications like edema and pulmonary congestion. You’d expect signs such as rapid weight gain, edema, elevated blood pressure, and possibly shortness of breath. Nursing care focuses on tracking fluid status with daily weights and strict input and output, enforcing fluid and sodium restrictions as ordered, monitoring for edema and lung sounds, and coordinating with the healthcare team to adjust dialysis or fluid removal. The other problems describe risks or symptoms not specifically tied to the fluid overload issue, such as infection risk, fatigue, or knowledge deficits.