A patient who has acute glomerulonephritis is hospitalized with hyperkalemia. Which information will the nurse monitor to evaluate the effectiveness of the prescribed calcium gluconate IV?

A. "You might require an anterior vaginal repair": Anterior vaginal repair is a surgical intervention used for stress incontinence caused by pelvic organ prolapse. It is not indicated for urge incontinence, which is related to overactive bladder and detrusor instability.

B. "You should restrict your intake of caffeine": Caffeine acts as a bladder stimulant and diuretic, which can worsen urinary urgency and frequency. Restricting caffeine intake is an important nonpharmacologic strategy to help reduce symptoms of urge incontinence.

C. "Your provider might prescribe anticholinergic medications.": Anticholinergic medications, such as oxybutynin, reduce detrusor muscle overactivity and help control involuntary bladder contractions.

D. "You should limit fluids in the evening.": Reducing evening fluid intake helps decrease nighttime urinary frequency and urgency. This strategy supports better bladder control and minimizes sleep disruption caused by nocturia in clients with urge incontinence.

E. "You might require intermittent urinary catheterization.": Catheterization is used for urinary retention, not urge incontinence. In urge incontinence, the bladder contracts too often and empties involuntarily, so catheterization would not address the underlying problem.

A. Collect a urine specimen for culture and sensitivity: This intervention is indicated when infection is suspected, in cases of fever, dysuria, or cloudy urine. The lab values here suggest hemoconcentration rather than infection, so a culture would not address the client’s fluid balance problem.

B. Continue routine care because the results are within the expected reference range: The results are not all within the expected range. The BUN of 32 mg/dL is elevated, and the hematocrit of 50% is high, both pointing toward dehydration.

C. Decrease the IV fluid infusion rate and limit oral fluid intake: Reducing fluid intake would be inappropriate in this case, since the client shows signs of fluid volume deficit. Decreasing fluids would worsen dehydration, elevate lab abnormalities further, and compromise perfusion.

D. Evaluate urine for amount and for specific gravity: Monitoring urine volume and specific gravity provides important information about hydration status and renal concentrating ability. Since the elevated BUN and hematocrit suggest dehydration, assessing urine helps guide fluid management and ensures appropriate therapy response.