A nurse is assessing a client who has chronic kidney disease for fluid volume increase. Which of the following provides a reliable measure of fluid retention?

A. Daily weight is the most reliable and sensitive indicator of fluid retention in clients with chronic kidney disease (CKD). Small changes in body weight (even 1–2 pounds per day) can reflect fluid accumulation or loss, allowing early detection of fluid volume overload. Nurses typically weigh clients at the same time each day, using the same scale and similar clothing, to monitor trends accurately. B. Serum sodium may provide indirect information about fluid balance, but it can be influenced by multiple factors, including diet, medications, and renal function. It is not a sensitive or reliable measure of daily fluid changes. C. Skin turgor assesses dehydration rather than fluid overload. In CKD, edema may be present even when skin turgor appears normal, making it an unreliable measure of fluid retention. D. While monitoring fluid intake and output is important, inaccuracies often occur due to missed measurements or insensible losses. It provides supportive information but is less precise than daily weight in detecting subtle fluid changes.