The nurse assesses the client for which clinical manifestation associated with a bone fracture?

Choice A reason: Escherichia coli (E. coli) is the most common cause of urinary tract infections (UTIs), accounting for 70-90% of cases. This gram-negative bacillus, found in the gastrointestinal tract, ascends the urethra to the bladder, adhering to uroepithelial cells via fimbriae. Its prevalence in fecal flora and ability to colonize the urinary tract make it the primary pathogen.

Choice B reason: Staphylococcus aureus is a gram-positive coccus that can cause UTIs, particularly in catheterized or hospitalized patients, but it accounts for less than 5% of cases. It is more commonly associated with skin or bloodstream infections. Its lower prevalence in UTIs compared to E. coli makes it a less likely cause.

Choice C reason: Pseudomonas aeruginosa, a gram-negative bacillus, is an opportunistic pathogen causing UTIs primarily in immunocompromised or catheterized patients. It accounts for less than 10% of UTIs. Its resistance to antibiotics and preference for nosocomial settings make it less common than E. coli in community-acquired infections.

Choice D reason: Klebsiella pneumoniae, another gram-negative bacillus, causes about 5-10% of UTIs, often in hospitalized or immunocompromised patients. While it can adhere to urinary epithelium, its prevalence is significantly lower than E. coli, which dominates due to its ubiquitous presence in the gut and urogenital proximity.

Choice A reason: A blood sugar of 50 mg/dL indicates hypoglycemia, not normal glucose levels (70-110 mg/dL). Symptoms like sweating and clamminess confirm this. Drinking water does not address hypoglycemia, as it lacks glucose to raise blood sugar, making this intervention inappropriate and potentially harmful.

Choice B reason: Hypoglycemia (50 mg/dL) with symptoms like sweating requires rapid glucose correction. Fruit juice with added sugar provides fast-acting carbohydrates (15-20g), raising blood sugar within minutes by stimulating glycogenolysis and glucose absorption. This is the most appropriate intervention to reverse hypoglycemia safely and effectively.

Choice C reason: Administering insulin during hypoglycemia (50 mg/dL) would further lower blood sugar, worsening symptoms and risking seizures or coma. Insulin drives glucose into cells, exacerbating the glucose deficit. This intervention is contraindicated and dangerous in the context of low blood sugar and neuroglycopenic symptoms.

Choice D reason: While consulting a healthcare provider may be needed for recurrent hypoglycemia, the immediate priority is correcting low blood sugar (50 mg/dL) with fast-acting carbohydrates. Delaying treatment by calling first risks prolonged hypoglycemia, potentially causing neurological damage, making this less appropriate than direct intervention.