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","B","C","E"]
Explanation
The correct answer isA, B, C and E.These interventions are consistent with the best practices for optimizing functional status in the elderly.
Some explanations for the choices are:.
• Choice A is correct because physical activity and exercise can help maintain muscle strength, joint mobility, balance and coordination, which are essential for functional independence and quality of life.
• Choice B is correct because adequate nutrition and hydration can prevent malnutrition, dehydration and electrolyte imbalance, which can impair physical and cognitive function and increase the risk of complications.
• Choice C is correct because managing chronic diseases and medications can prevent complications, adverse effects and polypharmacy, which can affect functional status and increase the need for health care services.
• Choice D is wrong because providing assistive devices and adaptive equipment is not an intervention to improve functional status, but rather to enhance mobility, safety and independence for patients who already have functional limitations.
The question asks for interventions to improve functional status, not to compensate for it.
• Choice E is correct because modifying the environment can reduce hazards, improve accessibility and facilitate self-care, which can promote functional independence and prevent injuries or falls.
The normal ranges for blood glucose and blood pressure for older adults with diabetes and hypertension are:.
• Blood glucose: 80-130 mg/dL before meals and less than 180 mg/dL after meals.
• Blood pressure: less than 140/90 mmHg or individualized based on comorbidities and risk factors.
Correct Answer is ["B","C","E"]
Explanation
The correct answer is B, C, and E.
Phenytoin (Dilantin) is an anticonvulsant medication that is used to control seizures.
It can have several side effects, some of which are serious and require medical attention.
Here are some explanations for each choice:.
A. Avoid drinking grapefruit juice while taking this medication.
This iswrongbecause grapefruit juice does not interact with phenytoin.However, grapefruit juice can affect the levels of other medications, such as statins, calcium channel blockers, and some antidepressants.
B. Brush your teeth gently with a soft-bristled toothbrush.This isrightbecause phenytoin can causegingival hyperplasia, which is an overgrowth of the gums that can lead to bleeding, infection, and difficulty chewing.
To prevent this, patients should practice good oral hygiene, avoid alcohol and tobacco, and see a dentist regularly.
A. Avoid drinking grapefruit juice while taking this medication B.
Brush your teeth gently with a soft-bristled toothbrush C.
Wear a medical alert bracelet or necklace at all times D.
Stop taking this medication if you develop a rash or fever E.
Have your blood levels checked regularly as directed by your provider
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