The nurse is providing care for older adult clients in an extended care facility. Which patient should be monitored for signs of urosepsis?

Choice a reason: Furosemide is a loop diuretic, which works by increasing the excretion of sodium and water in the urine. However, it also increases the excretion of potassium, leading to a significant risk of hypokalemia (low potassium levels). Patients on furosemide should have their potassium levels monitored regularly and may require potassium supplements to prevent hypokalemia.
Choice b reason: Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief and inflammation reduction. It does not typically affect potassium levels or cause hypokalemia. NSAIDs can affect kidney function, but they are not associated with causing low potassium levels.
Choice c reason: Acyclovir is an antiviral medication used to treat infections caused by herpes viruses. It does not have an impact on potassium levels and is not known to cause hypokalemia. Its primary side effects are related to kidney function and gastrointestinal issues, but it does not significantly alter electrolyte levels.
Choice d reason: Ranitidine is a histamine H2-receptor antagonist used to reduce stomach acid production. It is primarily used for treating conditions like acid reflux and peptic ulcers. Ranitidine does not affect potassium levels and is not associated with causing hypokalemia. Its side effects are generally mild and gastrointestinal in nature.

Choice a reason: Body weight is the most accurate measurement for determining fluid losses in clients undergoing hemodialysis. Weighing the client before and after dialysis allows healthcare providers to quantify the exact amount of fluid removed during the treatment. This is critical for managing fluid balance and ensuring the client does not experience excessive fluid removal, which can lead to hypotension and other complications.
Choice b reason: While monitoring blood pressure before and after hemodialysis is essential to assess the client's cardiovascular stability, it is not a direct measure of fluid loss. Blood pressure changes can be influenced by various factors such as fluid status, vascular resistance, and cardiac output, but they do not provide a precise measurement of fluid removal.
Choice c reason: Neck vein distention can indicate fluid overload or changes in intravascular volume, but it is not a precise method for quantifying fluid loss during hemodialysis. Neck vein distention is a subjective assessment and can be influenced by factors such as body position and venous pressure, making it less reliable for determining exact fluid loss.
Choice d reason: Abdominal girth measurement is typically used to assess ascites or abdominal distension, not fluid loss during hemodialysis. It is not a relevant measurement for clients undergoing hemodialysis, as it does not provide information about the volume of fluid removed during the treatment. Abdominal girth changes are more relevant for conditions such as liver disease or gastrointestinal issues.