The nurse is assessing an elderly patient’s skin turgor and notes that it is poor.

The nurse understands that this finding may be due to which of the following reasons?

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:.

•.

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.

•.

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 isA, B, and C.

These interventions are appropriate for a client who has impaired tactile sensation due to aging.

• Ais correct because monitoring the client’s skin for signs of injury or infection can help prevent complications such as pressure ulcers, burns, or infections that might go unnoticed by the client due to reduced sensitivity.

• Bis correct because teaching the client to avoid exposure to extreme temperatures can protect the client from thermal injuries such as frostbite or heatstroke that might not be felt by the client due to diminished thermoreception.

• Cis correct because encouraging the client to use assistive devices for mobility and balance can enhance the client’s safety and independence by compensating for the loss of proprioception and kinesthesia that might impair the client’s coordination and stability.

• Dis wrong because providing the client with sensory stimulation such as massage or music is not directly related to impaired tactile sensation due to aging.While sensory stimulation might have other benefits for the client’s well-being, it does not address the specific problem of reduced touch perception.

• Eis wrong because advising the client to wear loose-fitting clothing and shoes is not helpful for a client who has impaired tactile sensation due to aging.In fact, loose-fitting clothing and shoes might increase the risk of falls or injuries by creating friction or slipping off the client’s body.

Normal ranges for tactile sensation vary depending on the type of stimulus, the location of the skin, and the method of testing.

However, some general guidelines are:.

• Vibration sense: normal threshold is less than 10 μm at 30 Hz on the fingertip.

• Temperature sense: normal threshold is less than 1°C difference between two stimuli on the forearm.

• Pressure sense: normal threshold is less than 10 g/mm2 on the fingertip.

• Pain sense: normal threshold is less than 0.5 g/mm2 on the fingertip.