A health care provider has ordered vital signs every 4 hours.

The client’s 8:00 AM temperature was 99° F (37.2° C).

At 10 AM, the client reported chills.

A nurse takes the client’s temperature again. Which type of nursing action does this exemplify?

Choice A is wrong because women are more at risk for hip fractures than men.

This is partly because women lose bone density faster than men do, especially after menopause.

Choice C is wrong because an increase in estrogen will not weaken the bones. In fact, estrogen helps protect the bones from osteoporosis, which is a leading cause of hip fracture.

Some other risk factors for hip fracture include:

• Excessive alcohol and caffeine consumption
• Lack of physical activity
• Low body weight
• Tall stature
• Vision problems
• Dementia
• Medications that cause bone loss
• Cigarette smoking
• Institutional living, such as an assisted-care facility
• Increased risk for falls, related to conditions such as weakness, disability, or unsteady gait

Normal ranges for bone density vary by age and sex, but generally, a T-score of -1.0 or above is considered normal, while a T-score of -2.5 or below is considered osteoporotic. A T-score between -1.0 and -2.5 is considered osteopenic, which means low bone mass.

The nurse should obtain a sputum culture specimen before administering any antibiotics to the client with bacterial pneumonia.

This is because the sputum culture can help identify the causative organism and the appropriate antibiotic therapy.

Administering antibiotics before obtaining the sputum culture can alter the results and lead to ineffective treatment.

Choice B is wrong because azithromycin is an antibiotic that should be given after obtaining the sputum culture.

Choice C is wrong because coughing and deep breathing are important interventions to promote airway clearance and gas exchange, but they are not the priority actions for this client.

Choice D is wrong because offering clear liquids can help prevent dehydration and thin secretions, but they are not the most urgent action for this client.

Normal ranges for blood urea nitrogen (BUN) are 7 to 20 mg/dL and for creatinine are 0.6 to

1.2 mg/dL.

Elevated levels of these substances can indicate renal impairment, which can be a complication of bacterial pneumonia.

The nurse should monitor these levels and report any abnormalities to the health care provider.