A nurse is reinforcing teaching about confidentiality with a client. Which of the following statements should the nurse include in the teaching?

A. Nitrites negative: Nitrites in the urine are typically produced by certain gram-negative bacteria that convert nitrates to nitrites. A negative nitrite result suggests the absence of common bacterial urinary tract infection pathogens and is considered a normal finding.

B. Ketones positive: Positive urinary ketones indicate fat breakdown and possible metabolic imbalance. In adolescents, this may be associated with uncontrolled diabetes mellitus, prolonged fasting, eating disorders, or dehydration. The presence of ketones raises concern for diabetic ketoacidosis if accompanied by hyperglycemia, making provider notification necessary.

C. Uric acid 475 mg/24 hr: Normal 24-hour urinary uric acid excretion typically ranges from approximately 250 to 750 mg. A value of 475 mg/24 hr falls within expected limits and does not indicate metabolic or renal dysfunction requiring intervention.

D. Specific gravity 1.020: Normal urine specific gravity ranges from about 1.005 to 1.030, reflecting appropriate renal concentrating ability. A value of 1.020 indicates adequate hydration and kidney function, and it does not suggest pathology requiring provider notification.

A. The client was discharged to home without developing complications of immobility: Repositioning a client every 2 hours is a key intervention to prevent pressure injuries, improve circulation, and reduce the risk of complications such as skin breakdown, deep vein thrombosis, and pneumonia. Achieving discharge without immobility-related complications indicates that preventive measures were effective.

B. The client returned to the facility 2 days after being discharged due to a urinary tract infection: Development of a urinary tract infection shortly after discharge may be related to catheter use, incontinence, or urinary stasis, but frequent repositioning does not directly prevent UTIs. This outcome suggests a complication occurred despite nursing interventions.

C. The client developed a rash on their back and lower extremities: Skin rashes may indicate irritation, allergic reactions, or moisture-associated skin damage. Repositioning helps relieve pressure and reduce friction but does not directly prevent all types of rashes. The appearance of a rash reflects a complication related to skin integrity rather than an expected outcome.

D. The client refuses to eat because they are nauseated: Nausea and refusal of food are unrelated to repositioning frequency. While immobility can contribute to gastrointestinal stasis, this outcome does not reflect the effectiveness of repositioning interventions for preventing pressure injuries or related complications.