A nurse is providing teaching to a client who has a new diagnosis of fibromyalgia. Which of the following client statements indicates an understanding of the teaching?

Choice A rationale:
Urine collection from an indwelling catheter is a sterile procedure that requires aseptic technique to prevent contamination of the specimen and potential urinary tract infection. Assistive personnel (AP) may not have the necessary training in sterile technique and therefore should not be delegated this task. Additionally, the nurse needs to assess the patient for any signs of urinary tract infection or other complications before collecting the urine specimen, which is within the scope of nursing practice.

Choice B rationale:
Blood collection for PaCO2 (partial pressure of carbon dioxide) is an invasive procedure that requires assessment of the patient's condition, appropriate site selection, and proper technique to ensure accurate results. This task is within the scope of nursing practice and should not be delegated to AP.

Choice C rationale:
Wound drainage collection for culture also requires aseptic technique to prevent contamination of the specimen and ensure accurate results. The nurse needs to assess the wound for signs of infection, choose the appropriate collection method, and ensure proper labeling and transport of the specimen. This task is within the scope of nursing practice and should not be delegated to AP.

Choice D rationale:
Random stool specimen collection is a non-invasive procedure that does not require sterile technique. AP can be trained to collect random stool specimens safely and effectively, following standard precautions for handling body fluids.

Choice A rationale:
Serum creatinine is a waste product that is produced by muscle metabolism and is normally excreted by the kidneys.
When kidney function is impaired, creatinine levels in the blood increase, making it a sensitive and specific indicator of renal function.
It is considered one of the most reliable markers for assessing kidney function and is routinely used to screen for and monitor kidney disease.

Choice B rationale:
Serum sodium is an electrolyte that is regulated by the kidneys, but it is not a direct measure of renal function. Sodium levels can be affected by various factors, including fluid intake, medications, and hormonal imbalances.
While abnormal sodium levels can sometimes be a sign of kidney dysfunction, they can also occur due to other conditions, making it less specific as an indicator of renal function.
Choice C rationale:

Blood urea nitrogen (BUN) is another waste product that is produced by the breakdown of proteins and is normally excreted by the kidneys.
However, BUN levels can be influenced by factors other than kidney function, such as dietary protein intake, dehydration, and gastrointestinal bleeding.
This makes BUN less specific than serum creatinine as a marker of renal function.

Choice D rationale:
Urine-specific gravity measures the concentration of solutes in urine, which can provide some information about kidney function.
However, it is not as sensitive or specific as serum creatinine.
Urine-specific gravity can be affected by factors such as fluid intake and hydration status, which can make it less reliable as an indicator of renal function.