A nurse is caring for an adult client who has a fever of 39.4°C (103°F) and is receiving 0.9% sodium chloride IV at 125 mL/hr. Over the last hour, the nurse notes that the client's urine output is 20 mL. The nurse should report this finding to the provider and anticipate a prescription for what?

An antipyretic medication

A diuretic medication

A blood culture

A fluid bolus

Answer and Explanation

The Correct Answer is D

Choice A reason: An antipyretic medication is not the best answer because it does not address the client's low urine output. An antipyretic medication is a drug that lowers the body temperature by reducing the production of heat or increasing the loss of heat. It may help the client feel more comfortable, but it does not improve the kidney function or prevent dehydration.

Choice B reason: A diuretic medication is not the best answer because it may worsen the client's low urine output. A diuretic medication is a drug that increases the excretion of water and electrolytes by the kidneys. It may lower the blood pressure and reduce the fluid overload, but it may also cause dehydration, electrolyte imbalance, and kidney damage.

Choice C reason: A blood culture is not the best answer because it does not address the client's low urine output. A blood culture is a laboratory test that detects the presence of bacteria or other microorganisms in the blood. It may help identify the cause of the fever and guide the antibiotic therapy, but it does not improve the kidney function or prevent dehydration.

Choice D reason: A fluid bolus is the best answer because it may improve the client's low urine output. A fluid bolus is a rapid infusion of a large volume of fluid, usually isotonic saline or lactated Ringer's solution. It may increase the blood volume and pressure, improve the tissue perfusion, and stimulate the urine production. It may also help lower the fever by diluting the pyrogens and increasing the heat loss.

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Correct Answer is D

Explanation

Choice A reason: Drinking a minimum of 12 ounces of fluid with each meal is not recommended for a client who has dumping syndrome. Fluids can increase the gastric volume and accelerate the gastric emptying, leading to more severe symptoms. The nurse should advise the client to drink fluids between meals, not with meals.

Choice B reason: Choosing foods that are high in simple carbohydrates is not recommended for a client who has dumping syndrome. Simple carbohydrates can cause a rapid rise and fall of blood glucose levels, resulting in hypoglycemia and weakness. The nurse should advise the client to choose foods that are high in protein and fat, and low in sugar.

Choice C reason: Staying upright when eating and for 30 minutes afterward is not recommended for a client who has dumping syndrome. This position can facilitate the gastric emptying and worsen the symptoms. The nurse should advise the client to lie down after eating to slow down the gastric emptying.

Choice D reason: Eating several small meals daily spaced at equal intervals is recommended for a client who has dumping syndrome. This can help reduce the gastric volume and pressure, and prevent the rapid delivery of food into the small intestine. The nurse should advise the client to eat four to six small meals per day, and avoid skipping meals.

A. Call the primary provider and report that the client may be obstructed. B. Position the client supine and insert an NG tube. C. Administer a fleet enema as prescribed and remain with the client. D. Contact the primary provider promptly and report these signs of perforation.

Correct Answer is D

Explanation

Choice A reason: This is not the best response because it does not accurately describe the client's condition. Obstruction is a possible complication of diverticulitis, but it is not indicated by fever and abdominal rigidity. Obstruction is more likely to cause symptoms such as nausea, vomiting, constipation, and abdominal distension.

Choice B reason: This is not the best response because it can worsen the client's condition. Positioning the client supine and inserting an NG tube are interventions for gastric outlet obstruction, not diverticulitis. An NG tube can increase the risk of infection and perforation in the inflamed colon. Supine position can also increase the pressure on the abdomen and cause more pain and discomfort.

Choice C reason: This is not the best response because it can be harmful to the client. Administering a fleet enema is contraindicated for diverticulitis, as it can cause more inflammation, bleeding, or perforation in the colon. A fleet enema is a type of laxative that contains sodium phosphate and is used to relieve constipation or prepare for colonoscopy.

Choice D reason: This is the best response because it is the most appropriate and urgent action for the client. Contacting the primary provider promptly and reporting these signs of perforation is essential for the client's safety and treatment. Perforation is a life-threatening complication of diverticulitis, where the colon wall ruptures and causes peritonitis, which is inflammation of the abdominal cavity. Perforation can cause symptoms such as fever, abdominal rigidity, tenderness, and rebound pain. Perforation requires immediate surgical intervention and antibiotic therapy.

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A nurse is caring for an adult client who has a fever of 39.4°C (103°F) and is receiving 0.9% sodium chloride IV at 125 mL/hr. Over the last hour, the nurse notes that the client's urine output is 20 mL. The nurse should report this finding to the provider and anticipate a prescription for what?

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The nurse is caring for a client who has developed dumping syndrome while recovering from a bariatric surgery. What recommendation should the nurse make to the client?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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A nurse is caring for an adult client who has a fever of 39.4°C (103°F) and is receiving 0.9% sodium chloride IV at 125 mL/hr. Over the last hour, the nurse notes that the client's urine output is 20 mL. The nurse should report this finding to the provider and anticipate a prescription for what?