Applying the reporting rule day by day
She was taught two thresholds: call the clinic if her weight rises by 1 kg or more in 1 day or by 2 kg or more in 1 week. Reading the log one day at a time, the changes are Sunday to Monday -0.2 kg, Monday to Tuesday +0.3 kg, Tuesday to Wednesday +0.1 kg, and Wednesday to Thursday +1.2 kg (58.2 to 59.4 kg). The Thursday reading meets the 1-day rule, so she should have called that same morning as soon as she saw the weight. Friday and Saturday show a slight fall, but that does not undo the trigger that was already met.
| Day | Weight (kg) | Change from the day before |
|---|
| Sunday | 58.0 | Baseline |
| Monday | 57.8 | -0.2 |
| Tuesday | 58.1 | +0.3 |
| Wednesday | 58.2 | +0.1 |
| Thursday | 59.4 | +1.2 (meets the 1-day rule) |
| Friday | 59.3 | -0.1 |
| Saturday | 59.2 | -0.1 |
Why a sudden gain matters in heart failure
In heart failure, a rapid weight gain over a day or two is almost always fluid retention, not fat or muscle. One liter of retained fluid weighs about 1 kg, so a 1.2 kg overnight rise means roughly that much fluid has accumulated. Weight usually rises before breathlessness, orthopnea, or edema become obvious, which is why daily morning weights are the most sensitive home tool for catching early decompensation. Reporting promptly allows the clinic to adjust her furosemide and review sodium intake before she needs readmission.
Why the other choices are wrong
Saying no call was needed applies only the weekly rule; her largest gain within the week was 1.6 kg (57.8 to 59.4 kg), below 2 kg, but the two rules are independent and meeting either one is enough. Waiting for Friday's second weighing to confirm the gain delays treatment, because the rule calls for reporting as soon as the gain is seen. Calling on Wednesday because the weight had risen two days in a row treats a trend as a trigger, but the rises of 0.3 and 0.1 kg meet neither threshold.
Watch out! Exam items like this one hide the answer in the arithmetic. Calculate each day-to-day change and the change within the week separately, then check each against its own threshold.
Exam takeaway
Key point! Daily weights are taken every morning after voiding and before breakfast, on the same scale and in similar clothing. A gain of 1 kg or more in a day or 2 kg or more in a week is reported the same day, without waiting for confirmation. Teaching the daughter who cooks about low-sodium meals supports the plan, but the weight rule is what triggers the call.