Which information from a patient's urinalysis requires that the nurse notify the health care provider?

decreased pH

Increased protein

Increased WBC

Increase specific gravity

Answer and Explanation

The Correct Answer is B

A. Decreased pH: A lower urine pH can result from diet, such as high-protein intake, or metabolic conditions like acidosis. While it is important to note, a mildly acidic urine pH is not usually urgent and does not require immediate notification of the healthcare provider.

B. Increased protein: Proteinuria is a significant finding because it indicates possible glomerular damage or kidney disease. Persistent protein loss in the urine can contribute to nephrotic syndrome, fluid imbalance, and long-term renal impairment, making it a priority to report promptly.

C. Increased WBC: An elevated white blood cell count in urine suggests infection, such as a urinary tract infection. While important, this requires follow-up with a urine culture and treatment but is not as urgent as proteinuria, which may indicate progressive renal damage.

D. Increased specific gravity: A higher specific gravity usually reflects concentrated urine from dehydration or reduced fluid intake. This finding is generally reversible with hydration and does not necessarily indicate a pathologic renal condition requiring immediate provider notification.

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Correct Answer is D

Explanation

A. Take 3,000 mg of vitamin C daily: High doses of vitamin C are not recommended because excess vitamin C is metabolized into oxalate, which can increase the risk of calcium oxalate stone formation. This practice would worsen rather than prevent recurrence.

B. Eat 12 oz of animal protein daily: Excessive animal protein intake increases calcium and uric acid excretion while lowering urinary citrate, which promotes stone formation. Clients with calcium oxalate stones are advised to limit animal protein, not increase it.

C. Restrict calcium intake to one serving per day: Severe restriction of dietary calcium is not recommended. Adequate calcium intake is necessary because calcium binds oxalate in the gut, preventing absorption. Restricting calcium can increase oxalate absorption and stone risk.

D. Drink 3 L of fluid every day: Increasing fluid intake dilutes urine, reduces urinary supersaturation, and promotes passage of crystals before they aggregate into stones. Maintaining a high fluid intake is the most effective and recommended measure to prevent recurrence of calcium oxalate stones.

A. Catheter seal is broken B. sediments in urine C. absence of insertion date on the urinary bag D. dried defecation on catheter

Correct Answer is A

Explanation

A. Catheter seal is broken: A broken catheter seal compromises the closed drainage system, increasing the risk of catheter-associated urinary tract infection (CAUTI). Inserting a new sterile catheter restores a closed system and maintains infection control, which is critical for patient safety.

B. Sediments in urine: Sediment in the urine is common in patients with indwelling catheters and may indicate infection or crystallization, but it does not automatically require catheter replacement. The nurse should monitor and assess for other infection signs before deciding to change the catheter.

C. Absence of insertion date on the urinary bag: Missing documentation on the bag is a compliance and safety concern, but it does not necessitate immediate catheter replacement. The nurse should update records and ensure proper labeling.

D. Dried defecation on catheter: Fecal matter on the catheter tubing can be cleaned and disinfected externally. It does not require removal of the catheter unless sterility is compromised or infection risk increases due to contamination.

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Which information from a patient's urinalysis requires that the nurse notify the health care provider?

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Naxlex Comprehensive Predictor Exams

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