A nurse is caring for an older adult client who is 1 hr postoperative following a transurethral resection of the prostate and is receiving continuous bladder irrigation. Which of the following findings should the nurse report to the provider?

Rationale:

A. Initiate droplet precautions: Tuberculosis (TB) is an airborne disease, not droplet. Airborne precautions should be initiated, which include placing the patient in a negative pressure room and using a high-efficiency particulate air (HEPA) mask.

B. Perform chest percussion twice daily: Chest percussion is not a standard intervention for active tuberculosis unless there is a specific need related to chest physiotherapy for other respiratory issues, such as pneumonia.

C. Wear a high-efficiency particulate air mask: A high-efficiency particulate air (HEPA) mask is required when caring for clients with active TB. This mask is designed to filter out airborne particles, protecting healthcare workers from inhaling bacteria responsible for TB.

D. Obtain daily sputum specimens: While sputum specimens are crucial for diagnosing TB and assessing the treatment response, daily collection is not typically required unless the provider orders it for monitoring.

Rationale:

• Blood pressure: In glomerulonephritis, blood pressure elevation is commonly seen due to fluid retention and impaired kidney function, which leads to increased vascular resistance. This is more pronounced than in pyelonephritis, where blood pressure changes may be less severe.
• Respiratory rate: Both pyelonephritis and glomerulonephritis can cause an elevated respiratory rate. In pyelonephritis, it may be due to systemic infection or respiratory distress caused by fluid accumulation or sepsis. In glomerulonephritis, respiratory rate can increase due to fluid retention, leading to pulmonary congestion or difficulty breathing.
• Urinary output amount: Both conditions can cause decreased urinary output. In pyelonephritis, this may occur due to kidney inflammation or infection affecting kidney function. In glomerulonephritis, decreased output is due to glomerular damage that impairs filtration, leading to oliguria or anuria.
• Edema: Edema, particularly periorbital and in the extremities, is a hallmark of glomerulonephritis. The glomerular filtration barrier is damaged, causing protein loss in the urine and subsequent fluid retention. In contrast, edema is less common in pyelonephritis and usually occurs only in severe or advanced cases.
• Pain location: Flank pain is a key feature of pyelonephritis due to kidney infection or inflammation. The pain is usually localized to the back or side, in the area where the kidneys are located. Glomerulonephritis typically does not cause significant flank pain; it is more associated with systemic symptoms like edema, hematuria, and hypertension.