The healthcare provider prescribes a 24-hour urine specimen to be collected for creatinine clearance. The client is eager to go home and tells the nurse that the first sample was put in the urinal 2 hours ago. Which action should the nurse implement?
Begin the collection the next day.
Empty the sample into the 24-hour container.
Observe the sample for sediment.
Start collecting the specimen with the next void.
The Correct Answer is D
Choice A rationale
Beginning the collection the next day is not necessary. The 24-hour urine collection can be started immediately with the next void. Delaying the collection may cause unnecessary inconvenience and prolong the client’s hospital stay.
Choice B rationale
Emptying the sample into the 24-hour container is incorrect because the first urine sample should be discarded to ensure that the collection starts with an empty bladder. Including the initial sample would result in inaccurate measurement of creatinine clearance.
Choice C rationale
Observing the sample for sediment is not relevant to the collection process for creatinine clearance. The focus should be on ensuring accurate timing and collection of all urine produced within the 24-hour period.
Choice D rationale
Starting the collection with the next void is the correct action. The 24-hour urine collection should begin with an empty bladder, and the first urine of the day is discarded. The time is noted, and all subsequent urine is collected for the next 24 hours. This ensures accurate measurement of creatinine clearance.
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Correct Answer is ["B","C","E"]
Explanation
Choice A rationale
Encouraging increased fluid intake and measuring urinary output every 8 hours is not directly related to managing chronic pain. This intervention is more relevant for clients with conditions affecting fluid balance or renal function.
Choice B rationale
Providing comfort measures such as topical warm application and tactile massage can help alleviate chronic pain by promoting relaxation and improving blood circulation. These non- pharmacological interventions can be effective in managing pain and enhancing the client’s comfort.
Choice C rationale
Determining the client’s objective measure of pain using a numerical pain scale is essential for assessing the severity of pain and evaluating the effectiveness of pain management interventions. Accurate pain assessment is crucial for developing an appropriate plan of care.
Choice D rationale
Assisting the client to ambulate as much as possible during waking hours may not be feasible for clients with severe chronic pain. While physical activity is important, it should be balanced with the client’s pain levels and overall condition.
Choice E rationale
Implementing a 24-hour schedule of routine administration of prescribed analgesics ensures consistent pain relief and prevents breakthrough pain. Regular administration of analgesics is a key component of effectivepain management for clientswithchronic pain.
Correct Answer is D
Explanation
Choice A rationale
Double-checking all dosage calculations is a crucial step in preventing medication errors. This process involves verifying the calculations to ensure the correct dose is administered. However, while important, it is not the most effective technique on its own. It must be combined with other strategies to ensure comprehensive error prevention.
Choice B rationale
Identifying unusually large or small doses is essential in preventing medication errors. This involves recognizing doses that fall outside the typical range for a given medication and patient population. However, this technique alone does not address other potential errors, such as patient misidentification or incorrect medication administration.
Choice C rationale
Comparing the medication label to the order is a fundamental step in preventing medication errors. This process ensures that the correct medication is being administered as per the physician’s order. However, this technique alone does not address other potential errors, such as incorrect dosage calculations or patient misidentification.
Choice D rationale
Using at least two client identifiers before administering a dose is the most effective technique in preventing medication errors. This process ensures that the correct patient is receiving the correct medication. It addresses the critical issue of patient misidentification, which is a common cause of medication errors. By confirming the patient’s identity using two identifiers, such as name and date of birth, the risk of administering medication to the wrong patient is significantly reduced.
Choice E rationale
Involving and educating clients in medication administration is an important strategy in preventing medication errors. Educated clients are more likely to understand their medication regimen and recognize potential errors. However, this technique alone does not address other potential errors, such as incorrect dosage calculations or patient misidentification.
Choice F rationale
Documenting all medication in the electronic record as soon as it is given is a crucial step in preventing medication errors. This process ensures that there is an accurate and up-to-date record of all medications administered. However, this technique alone does not address other potential errors, such as incorrect dosage calculations or patient misidentification.