A nurse is teaching an older adult client about the benefits of social interaction for health and well-being.

Which of the following statements by the client indicates a need for further teaching?

The correct answer isA, D, and E.

Here is why:.

A. Elevated white blood cell count.

This is a sign of infection and inflammation in the body, which can be caused by a UTI.An elevated white blood cell count can also indicate a complication of UTI such as pyelonephritis (kidney infection) or sepsis (blood infection).

D. Altered mental status.

This is a common symptom of UTI in older adults, especially those with dementia or other cognitive impairments.UTIs can cause confusion, agitation, delirium, or behavioral changes in the elderly due to the effects of infection and inflammation on the brain.

E. Positive urine culture.

This is the definitive test to diagnose a UTI, as it identifies the type and number of bacteria present in the urine.A positive urine culture confirms the presence of a UTI and guides the appropriate antimicrobial treatment.

The other choices are wrong because:.

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B. Decreased serum creatinine level.

This is not a sign of UTI or its complications.

Serum creatinine is a measure of kidney function, and it usually increases when the kidneys are damaged or impaired.A decreased serum creatinine level may indicate other conditions such as liver disease, muscle wasting, or malnutrition.

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C. Increased urine specific gravity.

This is not a sign of UTI or its complications.

Urine specific gravity is a measure of urine concentration, and it usually increases when the body is dehydrated or has high levels of solutes in the urine.An increased urine specific gravity may indicate other conditions such as diabetes mellitus, heart failure, or dehydration.

Normal ranges for some of these tests are:.

• White blood cell count: 4,000 to 11,000 cells per microliter (mcL) of blood.

• Serum creatinine: 0.6 to 1.2 milligrams per deciliter (mg/dL) for men and 0.5 to 1.1 mg/dL for women.

• Urine specific gravity: 1.005 to 1.030.

The correct answer is C.

Ego integrity vs despair.

According to Erikson’s psychosocial theory, older adults face the challenge of looking back on their lives and evaluating their accomplishments and failures.

If they feel satisfied with their life course, they achieve a sense of ego integrity, which is a feeling of wholeness and coherence.

If they feel regretful or dissatisfied, they experience despair, which is a sense of hopelessness and bitterness.

Choice A is wrong because trust vs mistrust is the first stage of Erikson’s theory, which occurs in infancy.

It involves developing a basic sense of trust in oneself and others based on the quality of caregiving.

Choice B is wrong because generativity vs stagnation is the seventh stage of Erikson’s theory, which occurs in middle adulthood.

It involves contributing to society and the next generation through work, parenting, or other activities.

Choice D is wrong because identity vs role confusion is the fifth stage of Erikson’s theory, which occurs in adolescence.

It involves developing a stable and coherent sense of self and one’s role in society.

Normal ranges for Erikson’s stages are:.

• Trust vs mistrust: birth to 18 months.

• Autonomy vs shame and doubt: 18 months to 3 years.

• Initiative vs guilt: 3 to 6 years.

• Industry vs inferiority: 6 to 12 years.

• Identity vs role confusion: 12 to 18 years.

• Intimacy vs isolation: 18 to 40 years.

• Generativity vs stagnation: 40 to 65 years.

• Ego integrity vs despair: 65 years and older.