Which laboratory result indicates that a client with heart failure has fluid volume excess?

In the context of heart failure, a laboratory result indicating fluid volume excess can often be inferred from changes in specific markers related to hydration status. A BUN (Blood Urea Nitrogen) level of 8 mg/dL suggests a well-hydrated state, which is consistent with fluid volume excess. In cases of fluid overload, there tends to be a dilutional effect on the blood urea nitrogen levels, keeping them relatively low.

When assessing other markers:

• Urine specific gravity at 1.015 shows a relatively dilute urine, which could also suggest hydration; however, it does not provide as direct evidence of excess fluid volume as the BUN level does.

• A hematocrit level of 42% is within normal limits for most individuals and does not indicate fluid overload. Typically, with fluid volume excess, hematocrit levels would be lower due to dilution.

• A urine pH of 6.5 falls within the normal range and does not relate specifically to fluid volume status.

Overall, low BUN levels in the context of heart failure point towards a status of fluid overload rather than dehydration, making it the most indicative laboratory result of fluid volume excess.