A nurse is evaluating a hospitalized client who had an indwelling catheter removed four days ago. Which assessment findings suggest that this client has developed a Urinary Tract Infection (UTI)? Select all that apply.

Rationale for Choice A:
Making assessments every 15 minutes for four hours does not directly address the immediate concern of blood loss and potential hemodynamic instability. While close monitoring is essential, it's not the primary action in this situation.
Excessive blood loss can rapidly lead to hypovolemic shock, which requires prompt intervention to prevent serious complications.
Relying solely on frequent assessments without active interventions could delay crucial treatment and compromise patient safety.
Rationale for Choice B:
Documenting the data, removing the old dressing, and applying a new dressing might be necessary at some point, but it's not the most urgent priority in this case.
Removing the dressing could disrupt clot formation and potentially worsen bleeding.
Applying a new dressing without addressing the underlying bleeding might not effectively control the blood loss. Rationale for Choice C:
Applying a well-secured additional pressure dressing is the most appropriate immediate action to help control bleeding and prevent further blood loss.
It provides direct compression to the surgical site, promoting hemostasis and reducing blood flow. This action prioritizes stabilizing the patient's condition and preventing further complications.

Reporting the findings to the healthcare provider is crucial for timely assessment, diagnosis, and management of potential complications, such as hemorrhage or hematoma.
It ensures collaboration with the healthcare team and facilitates appropriate interventions based on the patient's specific needs.
Rationale for Choice D:
Reassuring the family that this is a common problem might provide some comfort, but it doesn't address the patient's immediate needs or the potential severity of the situation.
It's essential to prioritize patient safety and provide interventions to control bleeding, even if bleeding is a known potential complication.
Transparency and clear communication with the family are important, but they should not replace necessary medical interventions.

Choice A rationale:
Anticoagulant medications are the mainstay of treatment for thrombophlebitis. They work by preventing the formation of new blood clots and allowing the body's natural clot-dissolving mechanisms to break down existing clots. This helps to reduce the risk of the clot growing larger, breaking off, and traveling to the lungs (pulmonary embolism), which is a potentially life threatening complication.
Here is a detailed explanation of how anticoagulants work:
Blood clotting process: Blood clotting, also known as coagulation, is a complex process that involves multiple steps and factors. When a blood vessel is injured, a series of reactions occur to form a blood clot, which helps to stop bleeding.
Role of thrombin: Thrombin is a crucial enzyme in the clotting process. It converts fibrinogen, a soluble protein in the blood, into fibrin, which forms the mesh-like structure of blood clots.
Anticoagulants target thrombin: Anticoagulant medications work by inhibiting thrombin activity, thereby preventing the formation of fibrin and subsequent clot formation.
Different types of anticoagulants: There are several types of anticoagulant medications, each with different mechanisms of action. Some common types include:
Heparin: Heparin binds to antithrombin III, a natural anticoagulant in the body, and enhances its ability to inactivate thrombin and other clotting factors.
Warfarin: Warfarin blocks the production of vitamin K-dependent clotting factors in the liver.
Direct oral anticoagulants (DOACs): DOACs directly inhibit specific clotting factors, such as factor Xa or thrombin.
Choice B rationale:
Antibiotic medications are used to treat bacterial infections. Thrombophlebitis is not a bacterial infection, so antibiotics would not be effective in treating it.
Choice C rationale:
Antigen medications are not a category of medications. Antigens are substances that trigger an immune response in the body.
Choice D rationale:
Antihistamine medications are used to treat allergic reactions. They block the effects of histamine, a chemical released by the body during an allergic reaction. Antihistamines would not be effective in treating thrombophlebitis.