A client presents to the emergency department with complaints of urinary frequency, dysuria, and fever. Which of the following orders should the nurse carry out first?
Prepare the client for a CT scan
Begin broad spectrum antibiotics
Insert a Foley catheter
Obtain samples for urine culture and urinalysis
The Correct Answer is D
A. Prepare the client for a CT scan is not the first priority in this case. A CT scan might be considered if there is suspicion of complications like a kidney stone or abscess, but it is not the first intervention.
B. Begin broad spectrum antibiotics could be considered if a urinary tract infection (UTI) is suspected, but obtaining urine samples for culture and urinalysis is necessary first to confirm the diagnosis and guide antibiotic therapy.
C. Insert a Foley catheter is not indicated unless the patient is unable to void or there is a need for continuous monitoring of urine output, but it is not the first step.
D. Obtain samples for urine culture and urinalysis is the first step to confirm the diagnosis of a urinary tract infection (UTI) and determine the appropriate treatment. This will help guide the selection of antibiotics.
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Related Questions
Correct Answer is B
Explanation
A. DSW (Dextrose in water) is not specifically used for compatibility with antibiotics. It is an intravenous fluid that provides water and glucose, but its use is not based on antibiotic compatibility.
B. DSW (5% dextrose in water) provides free water to the body. In the case of acute dehydration and hypernatremia, the water helps to dilute the high sodium levels in the bloodstream, lowering the sodium concentration.
C. DSW does not contain higher-than-normal amounts of sodium. It contains only a small amount of sodium from the dextrose, and its primary role is to provide free water.
D. DSW is not used to pull water out of the interstitial space. Hypertonic solutions (like 3% saline) are used for that purpose, not DSW.
Correct Answer is C
Explanation
A. Decreasing fluid intake can actually increase the risk of urinary tract infections (UTIs) because it leads to concentrated urine and less frequent urination, which reduces the ability to flush bacteria from the urinary tract.
B. Cleansing the perineal area from back to front increases the risk of transferring bacteria from the rectum to the urethra, which is a common cause of UTIs. The correct technique is to cleanse from front to back.
C. Utilizing cotton rather than synthetic undergarments is beneficial because cotton is breathable and helps keep the genital area dry, reducing the risk of bacterial growth and infection.
D. Urinary tract infections are unavoidable in the elderly is not true. While the elderly may be at increased risk due to factors such as weakened immune systems, UTIs can often be prevented with proper hygiene, hydration, and lifestyle changes.
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