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","B","E"]

Explanation

A. Insulin glargine is a long-acting insulin that provides a steady release of insulin without a pronounced peak. This characteristic helps reduce the risk of hypoglycemia compared to shorter-acting insulins, making it an important point to educate the client on.
B. It is important for individuals with diabetes to monitor their blood glucose levels before and after exercise, as physical activity can significantly affect glucose levels. This practice helps the client avoid hypoglycemia during and after exercise, especially if they are on insulin.
C. Clients should monitor their blood glucose levels more frequently than weekly, especially if they are on insulin. Daily monitoring is typically recommended, especially if there are changes in diet, activity level, or medications. Weekly checks may not provide adequate insight into glucose control.
D. Partially correct but not a primary focus for immediate discharge teaching. While monitoring for microalbuminuria is important for long-term kidney health, it is not typically a direct action related to daily management. This would be part of routine assessments rather than immediate discharge instructions.
E. Rotating injection sites is crucial to prevent lipodystrophy and ensure consistent absorption of insulin. Educating the client on proper injection techniques, including site rotation, is essential for effective insulin management.

A. take vital signs. B. administer 1 mg glucagon subcutaneously. C. obtain a blood glucose reading. D. notify the physician.

Correct Answer is C

Explanation

A. While taking vital signs can provide useful information about the client's overall condition, it does not address the immediate concern of potential hypoglycemia. The priority is to assess blood glucose levels directly.
B. Glucagon can be administered in cases of severe hypoglycemia where the patient is unable to ingest glucose orally. However, before administering glucagon, the nurse should first check the blood glucose level to confirm hypoglycemia.
C. Checking the blood glucose level will provide immediate information about whether the client is experiencing hypoglycemia. If the blood glucose is low, appropriate treatment (such as administering glucose or a fast-acting carbohydrate) can be initiated. If it’s within normal limits, other causes for the symptoms can be explored.
D. While it may be necessary to notify the physician depending on the outcome of the blood glucose reading or if the client’s condition worsens, it is not the first action. Immediate assessment of the blood glucose level is essential to determine the correct course of action.

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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

The nurse is discharging a client who was just prescribed insulin glargine daily at 2100. Which of the following should be included in the teaching? (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","E"]

Explanation

A client on glipizide, a sulfonylurea, reports to the nurse feeling anxious, sweaty & has a headache. The nurse's initial action is to:

Correct Answer is C

Explanation

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?

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