Which long-term outcome is most important for the nurse to include in the plan of care for an older adult client with chronic pyelonephritis?
Manages activities of daily living independently.
Measures oral temperature daily.
Maintains blood pressure within normal limits.
Restricts fluid intake to 1 L/day.
The Correct Answer is C
Rationale:
A. Manages activities of daily living independently: Preserving functional independence is not a direct clinical outcome related to managing chronic pyelonephritis. The primary concern with this condition is preserving renal function and preventing long-term complications like hypertension.
B. Measures oral temperature daily: Monitoring temperature can help detect infections early, but chronic pyelonephritis may not always present with fever. It’s a short-term strategy and less critical than preventing progression to renal damage or cardiovascular complications.
C. Maintains blood pressure within normal limits: Chronic pyelonephritis can lead to kidney scarring, which often contributes to secondary hypertension. Controlling blood pressure is vital in slowing renal deterioration and preventing cardiovascular events, making it the most important long-term goal.
D. Restricts fluid intake to 1 L/day: Fluid restriction is not appropriate unless the client is in advanced kidney failure with fluid overload. Adequate hydration is usually encouraged to help flush bacteria from the urinary tract and support renal function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Currently prescribed medications: Medication history is important and may explain the confusion or fall, but it belongs in the Background section of SBAR. It is not the first or most urgent piece of information during provider communication.
B. Client's healthcare power of attorney: The presence of a power of attorney is relevant if decisions need to be made, especially if the client is confused. However, it does not take precedence when communicating the current clinical concern.
C. Increasing confusion of the client: This represents the Situation—the urgent issue prompting the call. Notifying the provider about a change in mental status is critical for rapid evaluation and decision-making, and should be stated first in SBAR communication.
D. Fall at home as reason for admission: The fall is part of the Background section and supports the context of the admission. However, it does not represent the immediate issue requiring provider action, which is the client’s new or worsening confusion.
Correct Answer is A
Explanation
Rationale:
A. Arrange an appointment with a pain specialist: A pain specialist can provide comprehensive strategies for managing chronic pain related to fibromyalgia. This includes pharmacologic and non-pharmacologic options tailored to the client's needs.
B. Form an interdisciplinary team for evaluation: While helpful in complex cases, a full team may not be necessary as the first step. It may delay direct pain management support that a pain specialist could initiate more quickly. Interdisciplinary care may follow specialist input.
C. Contact a hospice nurse for an evaluation: Hospice care is intended for clients with terminal illnesses and a life expectancy of six months or less. Fibromyalgia is a chronic, non-fatal condition, so this request indicates a need for pain support, not end-of-life care.
D. Ask for a consultation with a psychologist: A psychologist can help address emotional responses to chronic pain, but cannot directly manage physical symptoms. This should be a supportive measure after physical pain is addressed by a medical pain expert.
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