A nurse is caring for a client in a clinic who has foul, smelling urine, a low-grade fever of 37.7° C (100° F), and pain with urination. Which of the following should the nurse expect the health care provider to order?
A clean catch urinalysis and urine culture
Foley catheter placement
Broad-spectrum antibiotic
0.9% sodium chloride infusion at 100 ml/hr
WBC count
Blood cultures × 2
Correct Answer : A,C,E
A. A clean catch urinalysis and urine culture: A urinalysis and culture are essential to identify the presence of infection, type of bacteria, and appropriate antibiotic sensitivity.
B. Foley catheter placement: Foley catheters are not routinely indicated for suspected urinary tract infections (UTIs) unless there is an issue with urinary retention or other specific medical indication.
C. Broad-spectrum antibiotic: Initiating a broad-spectrum antibiotic may be appropriate while waiting for culture results to address infection.
D. 0.9% sodium chloride infusion at 100 ml/hr: IV fluids are not typically necessary for a UTI unless the patient is dehydrated or unable to take oral fluids.
E. WBC count: A WBC count can help assess the systemic inflammatory response and gauge the severity of the infection.
F. Blood cultures × 2: Blood cultures are generally reserved for cases where a systemic infection or sepsis is suspected, which is not indicated by this patient's symptoms alone.
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Correct Answer is ["A","C","D","E"]
Explanation
A. Ensure that the client's urine output is at least 1 ml/kg/hr. Adequate urine output is essential before administering IV potassium to ensure the kidneys are functioning properly and can handle the increased potassium load, preventing hyperkalemia.
B. Ensure potassium infusion is prepared with 5% dextrose solution. While IV potassium can be mixed with normal saline or dextrose solutions, the specific diluent will depend on the clinical scenario. This isn't necessarily a standard requirement, so it may not be appropriate for all situations.
C. Educate the client regarding high-potassium foods. Education on high-potassium foods helps the client maintain potassium levels after treatment, reducing the need for future supplementation.
D. Repeat blood serum potassium levels. Rechecking potassium levels ensures the patient reaches a safe and therapeutic range and helps monitor for signs of overcorrection or continued hypokalemia.
E. Cardiac monitoring during infusion. Cardiac monitoring is critical, as hypokalemia and potassium replacement can affect heart rhythm and lead to arrhythmias.
Correct Answer is C
Explanation
A. Share personal items like razors and toothbrushes. Sharing personal items that may come in contact with blood or body fluids, like razors and toothbrushes, increases the risk of spreading hepatitis, so clients should avoid sharing these items.
B. Drink alcohol in moderation to avoid liver strain. Clients with hepatitis should avoid alcohol entirely, as alcohol can worsen liver inflammation and damage, which would strain the liver further.
C. Wash your hands thoroughly after using the bathroom. Hand hygiene is crucial, especially for hepatitis A, which can spread through fecal-oral transmission. Washing hands can prevent the spread of the virus to others.
D. Avoid all physical activities to conserve energy. Although clients may need to rest, they do not need to avoid all physical activity. Light, tolerated activity can help maintain strength and prevent complications from immobility.