A client is receiving gentamicin and vancomycin IV for urosepsis. Which diagnostic study result should the nurse report to the primary care practitioner?

Urine negative for ketones.

Sodium 135 mg/dL and Potassium 3.5 mEq/L.

BUN 34 mg/dL and Creatinine 4.2 mg/dL.

White blood cell count 12,000/mm³.

Answer and Explanation

The Correct Answer is C

Choice A Reason
Urine negative for ketones is a normal finding and does not typically indicate an acute problem. Ketones in the urine can be a sign of uncontrolled diabetes or starvation, but their absence is expected in a well-nourished individual who is not in a state of diabetic ketoacidosis.

Choice B Reason
Sodium at 135 mg/dL and Potassium at 3.5 mEq/L are within normal ranges. The normal range for serum sodium is approximately 135-145 mEq/L, and for serum potassium, it is around 3.5-5.0 mEq/L. These values do not indicate an immediate concern for the patient with urosepsis.

Choice C Reason
A BUN of 34 mg/dL and Creatinine of 4.2 mg/dL are concerning. The normal range for BUN is approximately 6-20 mg/dL, and for Creatinine, it is about 0.6-1.2 mg/dL for males and 0.5-1.1 mg/dL for females. Elevated levels of BUN and Creatinine indicate impaired kidney function, which can be a complication of urosepsis and the nephrotoxic effects of gentamicin and vancomycin.

Choice D Reason
A white blood cell count of 12,000/mm³ is slightly elevated, which may be expected in a patient with an infection such as urosepsis. The normal range is approximately 4,500-11,000 WBCs/mm³. While this should be monitored, it does not require immediate reporting unless there is a significant change or it is outside the patient's baseline.

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

Explanation

Choice a reason:
Assessing capillary refill and the color of the extremity is essential for determining the vascular status of the limb. A normal capillary refill time is less than 2 seconds and indicates good blood flow. The color should be consistent with the rest of the body, without pallor or cyanosis, which could indicate compromised circulation.

Choice b reason:
Checking pedal pulses is another critical aspect of assessing vascular integrity. The presence of strong and equal pulses in both feet suggests that the blood supply to the lower extremities is not compromised.

Choice c reason:
While the ACE wrap and Velcro boot are part of the postoperative management to provide support and protection to the affected limb, and hanging weights might be used for traction, these are not part of the physiological assessment of the extremity.

Choice d reason:
Monitoring pin sites for signs of infection, such as redness, swelling, or discharge, is crucial in a client with ORIF. Infection can lead to complications that may affect the healing process and the integrity of the fixation.

Choice e reason:
Evaluating the temperature, sensation, and movement of toes helps in assessing for potential nerve damage or compartment syndrome. Any changes in these parameters should be reported immediately as they may signify serious complications.

A. Stop NSAIDs. B. Continue aspirin. C. Limit caffeine. D. Avoid alcohol. E. Eat large meals.

Correct Answer is ["A","C","D"]

Explanation

Choice A Reason:

Stopping NSAIDs is crucial for clients with PUD because NSAIDs can cause injury to the lining of the stomach or intestine, making it more vulnerable to damage from stomach acid. This can lead to the development or exacerbation of ulcers.

Choice B Reason:

Continuing aspirin may not be advisable for clients with PUD, as aspirin is an NSAID and can contribute to the development of peptic ulcers by inhibiting prostaglandin synthesis, reducing the protective mucosal layer, and increasing susceptibility to injury.

Choice C Reason:

Limiting caffeine is recommended for clients with PUD. Caffeine stimulates gastric acid secretion, which can exacerbate ulcer symptoms and impede the healing process.

Choice D Reason:

Avoiding alcohol is advised for clients with PUD. While there is mixed evidence on alcohol directly causing stomach ulcers, heavy alcohol consumption is considered a risk factor for developing stomach ulcers and can worsen the symptoms of existing ulcers.

Choice E Reason:

Eating large meals is not recommended for clients with PUD. It is better to eat smaller, more frequent meals to avoid overfilling the stomach and increasing gastric pressure, which can exacerbate symptoms.

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A client is receiving gentamicin and vancomycin IV for urosepsis. Which diagnostic study result should the nurse report to the primary care practitioner?

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