Which action will the nurse include in the plan of care to maintain the patency of a patient's left arm arteriovenous fistula?

A. Take phenazopyridine for at least 7 days: Phenazopyridine is a urinary analgesic and does not treat the underlying infection. It should be used only for symptom relief, usually for a short duration, and not as a substitute for the full course of antibiotics.

B. Phenazopyridine may cause photosensitivity: Photosensitivity is not a commonly reported side effect of phenazopyridine. The primary concern with this medication relates to its effects on urine color rather than skin sensitivity to sunlight.

C. Phenazopyridine may change the urine color: Phenazopyridine can turn urine a reddish-orange color, which is harmless but important for patients to understand to avoid alarm. Educating the patient about this expected effect improves adherence and reduces anxiety related to urine discoloration.

D. Take phenazopyridine before sexual course: Phenazopyridine is not indicated as a preventative or prophylactic measure for sexual activity. Its use is for symptomatic relief of urinary discomfort and should be coordinated with the prescribed antibiotic regimen.

A. Collect a urine specimen for culture and sensitivity: This intervention is indicated when infection is suspected, in cases of fever, dysuria, or cloudy urine. The lab values here suggest hemoconcentration rather than infection, so a culture would not address the client’s fluid balance problem.

B. Continue routine care because the results are within the expected reference range: The results are not all within the expected range. The BUN of 32 mg/dL is elevated, and the hematocrit of 50% is high, both pointing toward dehydration.

C. Decrease the IV fluid infusion rate and limit oral fluid intake: Reducing fluid intake would be inappropriate in this case, since the client shows signs of fluid volume deficit. Decreasing fluids would worsen dehydration, elevate lab abnormalities further, and compromise perfusion.

D. Evaluate urine for amount and for specific gravity: Monitoring urine volume and specific gravity provides important information about hydration status and renal concentrating ability. Since the elevated BUN and hematocrit suggest dehydration, assessing urine helps guide fluid management and ensures appropriate therapy response.