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. Mixing medications can alter their effectiveness and increase the risk of tube blockage. Each medication should be administered separately.
B. Flushing the NG tube with 30 mL of water after administering medications is important to ensure that the medications are cleared from the tube and absorbed properly by the patient. This also helps to prevent tube occlusion.
C. Diluting medications may not be necessary for all liquid medications, and it depends on the specific medication's guidelines. Each medication should be administered as directed.
D. The head of the bed should be elevated during and after medication administration to prevent aspiration. Keeping it flat is not recommended.
Correct Answer is C
Explanation
A. Thicken gravies with cornstarch is acceptable as it does not add significant sodium and can be a healthier alternative to flour or other thickening agents.
B. Fresh fruits are indeed a healthy snack option and are encouraged in a heart-healthy diet due to their low sodium and high fiber content.
C. Eating 2 cans of soup a day is concerning because many canned soups are high in sodium, which can exacerbate hypertension. This statement indicates a need for further teaching about sodium intake.
D. Replacing table salt with dried herbs is a positive change that promotes flavor without adding sodium, aligning with heart-healthy dietary recommendations.