A nurse is reviewing urinalysis results for four clients. Which of the following urinalysis results indicates urinary tract infection?

A. A positive antinuclear antibody (ANA) titer is a common finding in SLE. This test is often used as a screening tool for autoimmune diseases, and most patients with SLE will have a positive ANA. Therefore, this finding is expected.
B. The presence of protein in the urine (proteinuria) is indicative of kidney involvement, which can occur in SLE due to lupus nephritis. Given the client's difficulty urinating and other symptoms, this finding would be anticipated.
C. This statement is unlikely to be correct. In SLE, anemia is common due to various factors, including chronic disease, bone marrow involvement, or hemolysis. Therefore, an increased hemoglobin level would not be expected in this scenario.
D. This finding is not typically associated with SLE. SLE is primarily an autoimmune disease affecting the connective tissues, and thyroid function tests (like T3 and T4) would not show increased levels unless there is an underlying thyroid disorder. Therefore, this finding is not expected in SLE.
E. An elevated blood urea nitrogen (BUN) level may be anticipated, especially if there is kidney involvement due to lupus nephritis. Increased BUN can indicate impaired kidney function, which aligns with the client's symptoms of difficulty urinating.

A. Morphine is a strong opioid analgesic that is effective for managing severe pain, especially in acute situations like a vaso-occlusive crisis. Administering it intravenously allows for rapid onset of pain relief, which is critical given the severity of the patient’s symptoms. Continuous dosing (ATC—around the clock) ensures that pain is managed effectively.
B. Fentanyl patches are typically used for chronic pain management and take time to reach effective levels in the bloodstream (up to 12 hours or longer). In the case of acute severe pain from a vaso- occlusive crisis, this option would not provide immediate relief.
C. While ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can help relieve mild to moderate pain, it is not adequate for severe pain management. Additionally, in the setting of sickle cell disease, patients may be at risk for renal issues, making high doses of NSAIDs potentially harmful.
D. Hydromorphone is also a strong opioid analgesic; however, administering it orally may not be effective for severe pain management in an acute situation. IV administration of opioids is preferred for immediate and potent pain relief during a vaso-occlusive crisis.