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?

Rationale: A. The serum sodium level can fluctuate due to dilutional effects or dietary intake and does not accurately reflect total body fluid volume in clients with chronic kidney disease (CKD). B. Daily weight measurement is the most reliable indicator of fluid volume changes in clients with CKD. A weight gain of 1 kg (2.2 lb) corresponds to approximately 1 liter of fluid retention. Because fluid accumulation may not always be visible as edema, daily weights provide a sensitive and objective measure of fluid balance. C. Intake and output records are helpful but can be inaccurate or incomplete, especially when there are unmeasured losses (e.g., perspiration, respiration) or fluid shifts into tissues. D. Tissue turgor is an unreliable indicator in clients with CKD, especially in older adults, because skin elasticity changes with age and may not accurately reflect overall hydration or fluid overload.