# N3 · Assessing Target Weight

Target weight is reassessed from symptoms and trends, not inferred from one number.

![Infographic: N3 · Assessing Target Weight](https://urinenephrology.org/visual-reference/images/nursing-n03.png?v=20261003c)

## Compare the last 2–4 sessions

Verify pre/post weights, scale, clothing, and mobility aids. Compare achieved post-weight with the prescribed target and count sessions finishing above it. Reconcile recent hospital changes before assuming the target remains correct.

## Calculate gain; ask about symptoms

Interdialytic gain = today’s pre-weight minus the previous post-weight. Divide by target weight ×100 for percent gain. Pair it with orthopnea, edema, urine output, cramps, dizziness, recovery time, appetite, and loss of muscle.

## Examine in context

Review edema, lung findings, blood pressure, pulse, and treatment tolerance together. Neither absent crackles nor absent edema excludes congestion; low blood pressure does not by itself establish the correct target.

## Report competing clues

Repeated inability to reach target, worsening dyspnea, recurrent symptomatic hypotension, or falling weight with poor intake needs team review. Severe breathlessness, chest pain, or poor perfusion requires urgent assessment.

## Use the prescribed plan

Target-weight changes and any gradual probing require a clinician-directed plan. Do not independently increase fluid removal to correct one high blood pressure or assume every kilogram represents excess fluid.

## Request a target-weight review

Send recent weights, percent gain, lowest SBP, saline use, achieved removal, early stops, and nutrition changes. State the concern: persistent congestion, recurrent hypotension, or possible tissue loss. Confirm the authorized target and reassessment date.

## Source lessons

- [N3 Dry Weight Assessment Checklist](https://urinenephrology.org/mastery/maintenance-hd/nursing/N3-Dry-Weight-Assessment-Checklist.html)

Read alongside the full lessons; the findings and decisions shown here require the stated clinical context.