Which clinical manifestation will the nurse expect to observe in a patient with excessive white blood cells present in the urine?

Choice A reason: Replacing a PCA syringe ensures continued pain control but is less urgent than acute severe pain. PCA systems often have residual medication, allowing a brief delay without compromising pain management, so this is not the priority.

Choice B reason: Pre-medicating before walking prevents pain exacerbation but is less critical than addressing existing severe pain. Scheduled mobility can be delayed slightly to prioritize acute needs, making this a lower priority intervention.

Choice C reason: A patient with 8/10 pain and an immediate order indicates acute, severe distress requiring urgent intervention. Severe pain can elevate stress hormones, heart rate, and blood pressure, necessitating prompt medication to stabilize the patient and alleviate suffering.

Choice D reason: Scheduled maintenance medication maintains baseline pain control but is not urgent compared to acute 8/10 pain. Delaying a scheduled dose briefly is less likely to cause harm than untreated severe pain, making this a lower priority.

Choice A reason: Advancing the catheter 2.5-5 cm after urine flow is incorrect, as this risks advancing too far, potentially injuring the bladder or urethra. The catheter should be inserted until urine flows, then slightly further to ensure bladder placement.

Choice B reason: Contracting pelvic muscles during catheterization is not advised, as it may increase resistance or cause discomfort. Patients should relax to facilitate smooth catheter insertion and minimize trauma to the urethra.

Choice C reason: Inflating a balloon is specific to indwelling (Foley) catheters, not intermittent ones, which lack balloons. This instruction is irrelevant and could confuse the patient, as intermittent catheters are removed after bladder emptying.

Choice D reason: Lubricating the catheter tip with water or water-soluble lubricant reduces friction, easing insertion and minimizing urethral trauma. This is a critical step in self-catheterization to ensure safety and comfort, making it an essential instruction.