Which of the following is a risk factor for urinary tract infections (UTIs)?

Choice a reason: Taking the patient's blood pressure is not the first action to take in this situation. While monitoring vital signs is important, the immediate priority is to stop the bleeding. Addressing the bleeding at the access site takes precedence to prevent excessive blood loss and potential complications.
Choice b reason: Calling the physician is not the first action to take when the nurse notes bleeding from the vascular access site. While notifying the physician is important, the initial step must be to control the bleeding to ensure the patient's safety and stability.
Choice c reason: Applying pressure to the access site is the appropriate first action. This step is crucial to stop the bleeding and prevent further blood loss. Applying direct pressure helps to control the bleeding immediately, which is the primary concern in this situation. Once the bleeding is controlled, further actions such as notifying the physician and documenting the incident can be taken.
Choice d reason: Notifying the dialysis nurse is also not the first action to take. While it is important to inform the dialysis nurse and other members of the healthcare team, the priority is to control the bleeding by applying pressure to the access site. Once the bleeding is under control, the dialysis nurse can be notified to ensure proper follow-up and care.

Choice a reason: Laboratory results indicating a high level of an aminoglycoside can point to nephrotoxicity, which is a type of intrinsic renal injury. Aminoglycosides are antibiotics that can be toxic to the kidneys, causing damage to renal tissues. This condition is different from prerenal injury, which is related to reduced blood flow to the kidneys, not direct damage from toxins.
Choice b reason: A tumor obstruction in the right ureter is indicative of postrenal injury, which occurs due to obstruction of urine flow anywhere along the urinary tract. This kind of injury does not fall under the category of prerenal injury, which is due to factors causing reduced perfusion to the kidneys.
Choice c reason: A family history of polycystic kidney disease (PKD) suggests a genetic predisposition to intrinsic renal disease. PKD is a hereditary condition that leads to the formation of cysts in the kidneys, eventually impairing their function. This type of injury is not prerenal, as it results from structural abnormalities within the kidney itself.
Choice d reason: Impaired blood flow to the kidneys is the hallmark of prerenal injury. Prerenal injuries are caused by conditions that reduce renal perfusion, such as dehydration, heart failure, or shock. When the kidneys receive insufficient blood flow, they cannot function properly, leading to symptoms of renal insufficiency. Addressing the underlying cause to restore adequate blood flow is crucial in managing prerenal injury.