A client is admitted with sepsis secondary to a urinary tract infection. Of the following orders written by the health care provider, the nurse should first:

B. Obtaining blood and urine specimens for culture and sensitivity is a critical first step. These specimens help identify the causative organism(s) and determine their susceptibility to antibiotics, guiding appropriate antibiotic therapy. Prompt initiation of targeted antibiotic treatment is essential in managing sepsis effectively.
A. This action is important for assessing the presence of any urinary tract stones or debris, which can be helpful in diagnosing the cause of the urinary tract infection. However, it is not the first action the nurse should take in managing a client admitted with sepsis secondary to a urinary tract infection.
C. Administering antibiotics before obtaining appropriate cultures may lead to empirical treatment without knowing the specific pathogen causing the infection. It is important to obtain cultures first to guide antibiotic selection and ensure optimal treatment.
D. Contact precautions may be necessary if the client is found to have a multidrug-resistant organism or if there are specific infection control concerns. However, placing the client on contact precautions is not the first action the nurse should take in managing sepsis secondary to a urinary tract infection.

B. Bariatric surgery, such as gastric bypass or sleeve gastrectomy, is considered the most effective intervention for sustained weight loss in the extremely obese population. Bariatric surgery leads to significant weight loss and improvement in obesity-related comorbidities such as type 2 diabetes, hypertension, and obstructive sleep apnea.
A. Medications may help in conjunction with lifestyle modifications such as diet and exercise, but they are not typically the primary intervention for sustained weight loss in extremely obese individuals.
C. While dietary modifications are essential for weight loss and management, traditional dieting alone may not provide the most sustained weight loss in the extremely obese population.
D. Regular physical activity is important for overall health and can contribute to weight loss and weight maintenance. However, an exercise program alone may not provide the most sustained weight loss in the extremely obese population, especially without accompanying dietary modifications.