The practical nurse (PN) is caring for a client who has a fractured right tibia and fibula. To reduce swelling and promote comfort, the PN should place the client in which position?

Choice A reason: A respiratory rate of 28 breaths per minute indicates tachypnea, which can be a response to pain, anxiety, or hypovolemia. While it is important to monitor and manage respiratory status, this finding alone is not as critical as urine output when assessing the client's overall condition and fluid balance. Tachypnea should be reported, but it is not the most urgent parameter in this scenario.
Choice B reason: A blood pressure of 110/90 mm Hg is within a range that might be acceptable for some individuals, though the pulse pressure is narrow. In the context of a client receiving blood and fluid replacement, it is important to monitor blood pressure closely to ensure adequate perfusion. However, this reading does not immediately suggest a severe complication or shock, and other parameters might take precedence for immediate reporting.
Choice C reason: Urine output of 20 mL in the last hour is significantly low, indicating potential renal hypoperfusion or early signs of shock. Adequate urine output is a crucial indicator of renal perfusion and overall fluid status. Oliguria (reduced urine output) in this context suggests that the client's organs may not be receiving sufficient blood flow, which is a critical condition that requires prompt intervention. This finding should be reported immediately to the charge nurse to ensure timely and appropriate management.
Choice D reason: A pain score of 8 out of 10 indicates severe pain, which needs to be managed effectively to ensure the client's comfort and prevent further physiological stress. While addressing pain is important, it does not directly indicate a life-threatening condition compared to low urine output. Pain management should be part of the overall care plan, but reporting the critically low urine output takes priority in this situation.

Choice A reason: Checking mucous membranes can provide information about the client's hydration status. Dry mucous membranes can be a sign of dehydration, which may contribute to decreased urine output. This assessment is important to determine whether the client has adequate fluid balance.
Choice B reason: Ensuring that the catheter tubing is straight is essential to confirm that there are no kinks or obstructions that could be causing the reduced urine flow. Any obstruction in the catheter tubing could lead to a sudden decrease in urine output, and this check helps ensure patency.
Choice C reason: Auscultating lung sounds is crucial to assess for fluid overload or pulmonary complications, which can be associated with renal transplant patients. Abnormal lung sounds could indicate issues that may indirectly affect urine output and overall kidney function.
Choice D reason: Determining the dryness of bed linens helps assess whether the client might have experienced a leakage of urine outside the catheter system. If the bed linens are wet, it could indicate an issue with the catheter or bladder function that needs to be addressed.
Choice E reason: Irrigating the catheter to assess patency is a direct method to determine whether there is any blockage or obstruction in the catheter. This procedure helps ensure that the catheter is functioning correctly and allows for appropriate urine drainage.