A 72-year-old client is admitted to the medical-surgical unit with a diagnosis of acute pyelonephritis. The client complains of costovertebral tenderness. What it the most appropriate nursing intervention?

Notify the physician since this is a sign of deterioration.

Offer the client back massage to reduce the pain.

Place the client in prone position to limit vesicoureteral reflux.

Offer the client an analgesic if prescribed.

Answer and Explanation

The Correct Answer is D

A.   While costovertebral tenderness is significant and indicates kidney involvement, it is a common symptom of acute pyelonephritis and not necessarily a sign of deterioration. Immediate notification may not be warranted unless other concerning symptoms are present.
B.   Although back massage may seem comforting, it is not indicated in this scenario. The kidneys are inflamed, and massage could exacerbate pain or discomfort. It does not address the underlying condition or the pain effectively.
C.   The prone position is not typically recommended for clients with pyelonephritis. Instead, the client may be more comfortable in a position that does not put pressure on the kidneys, such as sitting up or lying on their back or side. This intervention does not directly address the pain or comfort of the client.
D.   Offering an analgesic is the most appropriate action. Pain management is crucial for the comfort of the client, and an analgesic can help alleviate the discomfort associated with costovertebral tenderness. If the physician has prescribed an analgesic, administering it would be in line with promoting comfort and addressing the client’s needs.

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Correct Answer is A

Explanation

This is the expected peak time for regular insulin. After administration, insulin will generally reach its maximum effectiveness in lowering blood glucose within this timeframe, making it crucial for the client to eat or take carbohydrates to prevent hypoglycemia.

A. maintenance of a healthy weight. B. use of low doses of insulin regular. C. oral hypoglycemic agents. D. self-monitoring of blood glucose.

Correct Answer is A

Explanation

A. Teaching the client about maintaining a healthy weight is crucial, as weight management is a key factor in preventing the progression from prediabetes to type 2 diabetes. Losing even a small percentage of body weight can significantly improve insulin sensitivity and reduce the risk of developing diabetes.

B. At a fasting plasma glucose level of 120 mg/dL, the client is not at the stage where insulin therapy is indicated. Insulin is typically reserved for those with diabetes who require it for glycemic control. The focus should be on lifestyle changes rather than pharmacological treatment at this time.
C. Similar to insulin, oral hypoglycemic agents are generally not prescribed for clients with prediabetes. The goal is to manage blood glucose levels through lifestyle changes, and medication is typically introduced only if the client progresses to diabetes.
D. While self-monitoring of blood glucose is important for individuals with diabetes, it may not be necessary for someone with a fasting plasma glucose level of 120 mg/dL unless specifically indicated by a healthcare provider. Education could include how to monitor if they develop diabetes in the future, but the immediate focus should be on prevention strategies.

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A 72-year-old client is admitted to the medical-surgical unit with a diagnosis of acute pyelonephritis. The client complains of costovertebral tenderness. What it the most appropriate nursing intervention?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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