A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?
Urine is cloudy after sitting in the urinal for 6 hours.
First-voided urine in the morning has a strong odor.
Urine output of 175 mL in the past 8 hours.
Urine output of 2,200 mL in the past 24 hours.
The Correct Answer is C
A. Cloudy urine may indicate sediment or the presence of protein but does not necessarily require immediate notification to the provider.
B. A strong odor in the first-voided urine can be normal or due to dehydration or dietary factors, and does not immediately warrant concern.
C. A urine output of 175 mL in 8 hours is significantly low and indicates possible oliguria, which is a concern for impaired renal function and should be reported to the provider.
D. A urine output of 2,200 mL in 24 hours can indicate normal or excessive output (polyuria), but it is less concerning than oliguria and does not require immediate notification.
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Correct Answer is B
Explanation
A. Using an alcohol rub when hands are visibly soiled is incorrect; hands should be washed with soap and water in such cases.
B. Rubbing all surfaces of the hands with an alcohol rub for 20 to 30 seconds is an appropriate practice for effective hand hygiene when hands are not visibly soiled, ensuring thorough coverage of all hand surfaces.
C. Gloves are not a substitute for hand hygiene; hands should be washed before putting on gloves and after removing them to prevent contamination.
D. Even if an individual does not have an infection, they can still carry pathogens on their hands that may infect others, highlighting the necessity of proper hand hygiene.
Correct Answer is A
Explanation
A. Checking the client for allergies is the first step in ensuring the safety of medication administration; it is crucial to verify that the client does not have any known allergies to the medication before proceeding.
B. Documenting that the medication was administered should occur after the medication has been given, not before.
C. Mixing the medication at the client’s bedside is an important step, but it should be done only after confirming that the medication is appropriate for the client.
D. Determining the client's response to the medication occurs after administration, making it a follow-up action rather than a first step.