A nurse is caring for a client who has cholecystitis with cholelithiasis and obstruction of the common bile duct. The nurse should expect the client's urine to appear which of the following colors?

Pale yellow

Red

Greenish-brown

Dark and concentrated

Answer and Explanation

The Correct Answer is C

Choice A reason: Pale yellow is the normal color of urine, indicating adequate hydration and no bilirubin in the urine. Bilirubin is a pigment that is produced when red blood cells are broken down. It is normally excreted in the bile, but if the bile duct is obstructed, it can accumulate in the blood and urine, causing jaundice and dark urine.

Choice B reason: Red urine can indicate blood in the urine, which can be caused by various conditions such as urinary tract infection, kidney stones, trauma, or cancer. It is not related to bile duct obstruction or cholecystitis.

Choice C reason: Greenish-brown urine can indicate bilirubin in the urine, which can be caused by bile duct obstruction or liver disease. It is a sign of cholestasis, which is a reduced or stopped flow of bile. The nurse should monitor the client for other signs of cholestasis such as jaundice, clay-colored stools, pruritus, and abdominal pain.

Choice D reason: Dark and concentrated urine can indicate dehydration, which can be caused by various factors such as fluid loss, fever, vomiting, or diarrhea. It is not related to bile duct obstruction or cholecystitis.

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Correct Answer is D

Explanation

Choice A reason: A client who has a urine specific gravity of 1.010 is not dehydrated. Urine specific gravity is a measure of the concentration of solutes in the urine. A normal range is 1.005-1.030, which means that the urine is neither too dilute nor too concentrated. A high urine specific gravity (>1.030) indicates dehydration, as the urine becomes more concentrated due to fluid loss. A low urine specific gravity (<1.005) indicates overhydration, as the urine becomes more dilute due to fluid excess.

Choice B reason: A client who has a hematocrit of 42% is not dehydrated. Hematocrit is the percentage of red blood cells in the blood. A normal range is 36-46% for women and 40-54% for men. A high hematocrit (>54% for men and >46% for women) indicates dehydration, as the blood becomes more viscous due to fluid loss. A low hematocrit (<40% for men and <36% for women) indicates overhydration, as the blood becomes more diluted due to fluid excess.

Choice C reason: A client who has a temperature of 39 °C may or may not be dehydrated. Temperature is a measure of the body's heat production and regulation. A normal range is 36.5-37.5 °C. A high temperature (>37.5 °C) indicates fever, which can be caused by various factors, such as infection, inflammation, or medication. Fever can also cause dehydration, as the body loses fluid through sweating and increased respiration. However, fever is not a specific sign of dehydration, as there may be other causes or contributing factors.

Choice D reason: A client who has a weight loss of 2.2 kg in 24 hr is dehydrated. Weight loss is a measure of the change in the body's mass over time. A normal range is 0.5-1 kg per week. A rapid weight loss (>1 kg per day) indicates dehydration, as the body loses fluid through various routes, such as urine, stool, sweat, or vomit. Weight loss is a sensitive and reliable sign of dehydration, as it reflects the amount of fluid loss.

A. Fatty stools B. Tenderness in the left upper abdomen C. Ecchymosis of the extremities D. Pale-colored urine

Correct Answer is A

Explanation

Choice A reason: This is a correct finding for a client with an obstruction of the common bile duct. Fatty stools are caused by the reduced or absent flow of bile into the intestine, which impairs the digestion and absorption of fats.

Choice B reason: This is not a correct finding for a client with an obstruction of the common bile duct. Tenderness in the left upper abdomen may indicate a problem with the spleen, the stomach, or the pancreas, but not the bile duct.

Choice C reason: This is not a correct finding for a client with an obstruction of the common bile duct. Ecchymosis of the extremities is a bruising of the skin due to bleeding under the surface. It may be caused by trauma, medication, or bleeding disorders, but not by bile duct obstruction.

Choice D reason: This is not a correct finding for a client with an obstruction of the common bile duct. Pale-colored urine is a sign of dilute or low concentration of urine, which may be caused by excessive fluid intake, diabetes insipidus, or kidney failure, but not by bile duct obstruction.

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A nurse is caring for a client who has cholecystitis with cholelithiasis and obstruction of the common bile duct. The nurse should expect the client's urine to appear which of the following colors?

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