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 .
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Related Questions
Correct Answer is D
Explanation
You can do any of the above options, depending on your preference and medical condition.
Erectile dysfunction (ED) is the inability to get and maintain an erection for sexual activity.
It can be caused by physical or psychological factors, or both.
ED can affect your self-esteem, stress level and relationship quality.
There are different treatment options for ED, and they work in different ways.
Some of the most common ones are:.
• Oral medicationssuch as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) or avanafil (Stendra).
These drugs enhance the effects of nitric oxide, a chemical that relaxes the muscles in the penis and increases blood flow.
You need to take them before sexual activity, and they only work if you are sexually stimulated.
They are not safe for everyone, especially if you have heart problems, low blood pressure, liver disease or certain eye conditions.They can also cause side effects such as headache, flushing, nasal congestion or indigestion.
• Penile self-injectionssuch as alprostadil (Caverject, Edex) or papaverine (OraVerse).
These are shots of medicine that you inject into the base or side of your penis with a fine needle.
They cause an erection by dilating the blood vessels in the penis.
The erection lasts about 20 to 30 minutes, and you need to use them only when needed.They can cause side effects such as bleeding, pain, priapism (a prolonged and painful erection) or fibrous tissue formation.
• Alprostadil urethral suppository(Muse).
This is a tiny pellet of medicine that you insert into your urethra (the tube that carries urine out of the body) with a special device.
It works by expanding the blood vessels in the penis and causing an erection.
The erection lasts about 30 to 60 minutes, and you need to use it only when needed.It can cause side effects such as burning, pain, bleeding or infection.
• Vacuum erection device(VED).
This is a plastic tube that you place over your penis and pump out the air to create a vacuum.
This draws blood into the penis and causes an erection.
You then slide a rubber ring around the base of your penis to keep the blood in place.
The erection lasts as long as the ring is on, up to 30 minutes.
You need to use it only when needed.It can cause side effects such as bruising, numbness, pain or difficulty ejaculating.
• Penile implant surgery.
This is a procedure where inflatable or bendable devices are surgically placed on both sides of your penis.
You can control when and how long you have an erection by inflating or deflating the devices with a pump or a switch.This is a permanent solution for ED, but it requires surgery and has risks of infection, mechanical failure or erosion.
Other treatment options for ED include hormone therapy, psychotherapy, lifestyle changes and natural remedies.
However, these may not be as effective or safe as the ones mentioned above.
The best treatment option for you depends on your personal preference, medical condition, cost and availability.
You should talk to your doctor about the benefits and risks of each option and choose the one that suits you best.
Correct Answer is C
Explanation
The correct answer is C.
Living arrangements and social support.
This is because living arrangements and social support are some of the environmental factors that can influence the psychosocial changes in older adults.Psychosocial changes refer to the changes in mental and emotional well-being, social relationships, and roles that occur as people age.Environmental factors are the external conditions or circumstances that affect a person’s life.
Choice A is wrong because physical health and functional status are not environmental factors, but rather biological factors that affect the aging process.Physical health and functional status can influence the psychosocial changes in older adults, but they are not part of the environment.
Choice B is wrong because cognitive conditions and memory loss are also not environmental factors, but rather neurological factors that affect the brain function of older adults.Cognitive conditions and memory loss can also influence the psychosocial changes in older adults, but they are not part of the environment.
Choice D is wrong because hormonal changes and sensory impairments are also not environmental factors, but rather physiological factors that affect the body function of older adults.Hormonal changes and sensory impairments can also influence the psychosocial changes in older adults, but they are not part of the environment.
Living arrangements and social support are environmental factors because they depend on the availability, accessibility, and quality of housing, transportation, community services, family networks, and social interactions that older adults have in their surroundings.Living arrangements and social support can influence the psychosocial changes in older adults by affecting their sense of independence, identity, belonging, security, and satisfaction.
Therefore, living arrangements and social support are some of the environmental factors that can influence the psychosocial changes in older adults.
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