A nurse in a health clinic is caring for a client. Click to highlight the findings that the nurse should report to the provider. To deselect a finding, click on the finding again.

Nurse's Notes

0930:

• Client reports 2-day history of urinary frequency, burning on urination, and lower back and suprapubic pain. States developed a fever of 39.3°C (102.8°F) this morning.
• Oriented x-4, answers questions appropriately.
• S1, S2, on auscultation. Lungs clear on auscultation.
• Bowel sounds x 4 quadrants active, denies nausea or vomiting.

0945:

• Request client provide clean-catch urinary specimen for testing.
• Urinalysis results reviewed.

Vital Signs 0930:

• Temperature: 39.3°C (102.8°F)
• Heart rate: 113/min
• Respiratory rate: 24/min
• Blood pressure: 122/68 mm Hg
• Oxygen saturation: 96% on room air

Diagnostic Results 1030:

Urinalysis

• Appearance: Cloudy
• Color: Amber yellow
• Odor: Aromatic
• pH: 8.0 (Reference: 4.6 to 8.0)
• Protein: 6.5 mg/dL (Reference: 0 to 8 mg/dL)
• Specific gravity: 1.035 (Reference: 1.005 to 1.030)
• Leukocyte esterase: Positive
• Nitrites: Present
• Ketones: None
• Bilirubin: None

Choice A reason:
Injecting air into the short-acting insulin vial is the first action to be taken. When mixing short-acting and intermediate-acting insulins in the same syringe, the first step is to inject air into the short-acting insulin (clear) vial. This helps equalize the pressure within the vial, making it easier to withdraw the correct dose of insulin
Choice B reason:
Drawing up the desired dose of intermediate-acting insulin into the same syringe is incorrect because it is the last step to be taken.
Choice C reason:
Drawing up the desired dose of short-acting insulin into the syringe is incorrect because it is the third step to be taken.
Choice D reason:
Inject air into the intermediate-acting insulin (cloudy) vial is incorrect because it is the second step to be taken

Choice A reason:
A registered dietitian is not appropriate as he or she can provide nutritional assessment and guidance to ensure the client's dietary needs are met.
Choice B reason:
A speech-language pathologist is not appropriate because it is crucial for addressing communication and swallowing difficulties that can arise from a stroke.
Choice C reason:
Occupational therapy is the right choice. Clients who have had a stroke often experience difficulties with activities of daily living (ADLs) due to the physical and cognitive changes that can result from the stroke. Occupational therapists are specialized in helping individuals regain or develop the skills needed to perform daily activities and tasks. They can assist stroke survivors in regaining independence in activities such as dressing, grooming, bathing, and feeding.
Choice D reason:
A physical therapist can assist with mobility and improving physical functioning, but since the question specifically mentions assistance with morning ADLs, the occupational therapist is the most appropriate choice.