A 72-year-old client is admitted to the medical-surgical unit with a diagnosis of acute pyelonephritis. The client complains of costovertebral tenderness. What it the most appropriate nursing intervention?

Notify the physician since this is a sign of deterioration.

Offer the client back massage to reduce the pain.

Place the client in prone position to limit vesicoureteral reflux.

Offer the client an analgesic if prescribed.

Answer and Explanation

The Correct Answer is D

A.   While costovertebral tenderness is significant and indicates kidney involvement, it is a common symptom of acute pyelonephritis and not necessarily a sign of deterioration. Immediate notification may not be warranted unless other concerning symptoms are present.
B.   Although back massage may seem comforting, it is not indicated in this scenario. The kidneys are inflamed, and massage could exacerbate pain or discomfort. It does not address the underlying condition or the pain effectively.
C.   The prone position is not typically recommended for clients with pyelonephritis. Instead, the client may be more comfortable in a position that does not put pressure on the kidneys, such as sitting up or lying on their back or side. This intervention does not directly address the pain or comfort of the client.
D.   Offering an analgesic is the most appropriate action. Pain management is crucial for the comfort of the client, and an analgesic can help alleviate the discomfort associated with costovertebral tenderness. If the physician has prescribed an analgesic, administering it would be in line with promoting comfort and addressing the client’s needs.

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Correct Answer is ["C","D","E"]

Explanation

A. Tamsulosin primarily affects urinary function and is not directly related to glucose metabolism or insulin action. It does not significantly contribute to hypoglycemic events.
B. While urinary retention can lead to discomfort and potential complications, it does not have a direct impact on blood glucose levels or increase the risk of hypoglycemia. However, if it results in increased stress or medication changes, it could indirectly affect glucose management.
C. Physical activity, such as jogging, can increase the risk of hypoglycemia in individuals with Type 1 diabetes, especially if they do not adjust their insulin or carbohydrate intake accordingly. Exercise can enhance insulin sensitivity and cause blood glucose levels to drop.
D. Alcohol can increase the risk of hypoglycemia, particularly in individuals with diabetes, because it can inhibit gluconeogenesis (the liver's ability to produce glucose). Drinking a significant amount of alcohol, especially without food, can lead to dangerously low blood sugar levels.
E. Metoprolol, a beta-blocker, can mask the symptoms of hypoglycemia (such as increased heart rate and tremors), making it more difficult for the individual to recognize when they are hypoglycemic. This can lead to delayed treatment and increased risk of severe hypoglycemia.

A. monitor the client closely until dinner arrives. B. have the client drink 4 oz. of orange juice. C. give the client 3 tbsp. of sugar dissolved in 4 oz. of grape juice to drink. D. have the client dissolve a small piece of hard candy in their mouth.

Correct Answer is B

Explanation

A. While monitoring is important, doing nothing to address the hypoglycemia is not safe. A blood glucose level of 50 mg/dL is low and requires immediate intervention to prevent more severe hypoglycemic symptoms or complications.
B. This is a suitable option for treating mild to moderate hypoglycemia. Orange juice is a quick source of carbohydrates and can effectively raise blood glucose levels. Four ounces typically provides enough sugar to help increase the client's blood glucose level before dinner is served.
C. While this option would also effectively raise blood glucose, it is more complicated than simply having the client drink orange juice. The sugar may take additional time to dissolve, and grape juice may not be readily available. In an acute situation, simplicity and speed are key.
D. While hard candy can raise blood glucose levels, it may take longer to dissolve and provide sufficient glucose quickly compared to liquid sources like orange juice or grape juice. Additionally, the amount of candy needed may not be clear, making this a less reliable option in an urgent situation.

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A 72-year-old client is admitted to the medical-surgical unit with a diagnosis of acute pyelonephritis. The client complains of costovertebral tenderness. What it the most appropriate nursing intervention?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse that which of the following activities/conditions increases complications of hypoglycemia for the individual with type 1 diabetes? (SELECT ALL THAT APPLY)

Correct Answer is ["C","D","E"]

Explanation

At 1630 a Type I diabetic client's blood glucose level is 50 mg/dl. The client is alert; however, dinner will not be served until 1715. The nurse's initial action should be to:

Correct Answer is B

Explanation

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