The nurse is reviewing the laboratory results of an older adult client who has a urinary tract infection (UTI).
Which of the following findings should alert the nurse to a possible complication of UTI in older adults?
(Select all that apply.).
Elevated white blood cell count.
Decreased serum creatinine level.
Increased urine specific gravity.
Altered mental status.
Positive urine culture.
Correct Answer : A,D,E
The correct answer is A, 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 .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is A.
Dehydration.
Poor skin turgor means that the skin takes longer to return to its normal position after being pinched or pulled.
This is a sign of dehydration, which means the body does not have enough fluid.
Dehydration can be caused by not drinking enough water, vomiting, diarrhea, fever, diabetes, or other conditions that affect fluid balance.
Choice B is wrong because malnutrition does not directly affect skin turgor.
Malnutrition means the body does not get enough nutrients from food.
This can cause various problems, such as weight loss, muscle wasting, poor wound healing, and infections.
However, malnutrition does not cause the skin to lose its elasticity.
Choice C is wrong because loss of subcutaneous fat does not cause poor skin turgor.
Subcutaneous fat is the layer of fat under the skin that helps insulate the body and store energy.
As people age, they tend to lose some subcutaneous fat, especially in the face and hands.
This can make the skin look thinner and more wrinkled, but it does not affect how quickly the skin snaps back after being pinched.
Choice D is wrong because reduced collagen fibers do not cause poor skin turgor.
Collagen is a protein that gives the skin its strength and structure.
As people age, they produce less collagen, which can make the skin sag and lose firmness.
However, collagen does not affect the skin’s ability to retain water and return to its normal shape after being stretched.
Normal ranges for skin turgor vary depending on the age and location of the skin.
In general, healthy skin should return to its normal position within 2 seconds after being pinched.
In children and young adults, skin turgor can be tested on the abdomen or forearm.In elderly people, skin turgor can be tested on the clavicle (collar bone), sternum (breastbone), forehead, or inner thigh.These sites are less affected by skin wrinkling and aging.
Correct Answer is D
Explanation
The correct answer isD.
All of the above.
The nurse should take all of the actions listed to provide effective pain management for the older adult client who has depression and chronic pain in his lower back.
• Choice Ais correct because assessing the pain using a valid and reliable pain scale is essential for determining the severity and impact of pain, as well as monitoring the response to treatment.
• Choice Bis correct because administering analgesic medications as prescribed can help reduce pain and improve function.
The nurse should also monitor for effectiveness and side effects, especially in older adults who may have altered drug metabolism, polypharmacy, and increased risk of adverse events.
• Choice Cis correct because providing non-pharmacological interventions can enhance pain relief, reduce medication use, and address the biopsychosocial aspects of pain.
Massage, heat or cold therapy, relaxation techniques, and distraction are some examples of non-pharmacological interventions that can be used for chronic pain in older adults.
• Choice Dis correct because it includes all of the above actions, which are part of a multimodal approach to pain management that is recommended by clinical guidelines.
4 7 A multimodal approach can improve pain outcomes, reduce side effects, and address the complex needs of older adults with chronic pain.
A. Assess the location, intensity, quality and duration of the pain using a pain scale B.
Administer analgesic medications as prescribed and monitor for effectiveness and side effects C.
Provide non-pharmacological interventions such as massage, heat or cold therapy, relaxation techniques or distraction D.
All of the above
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