A client is receiving gentamicin and vancomycin IV for urosepsis. Which diagnostic study result should the nurse report to the primary care practitioner?

Urine negative for ketones.

Sodium 135 mg/dL and Potassium 3.5 mEq/L.

BUN 34 mg/dL and Creatinine 4.2 mg/dL.

White blood cell count 12,000/mm³.

Answer and Explanation

The Correct Answer is C

Choice A Reason
Urine negative for ketones is a normal finding and does not typically indicate an acute problem. Ketones in the urine can be a sign of uncontrolled diabetes or starvation, but their absence is expected in a well-nourished individual who is not in a state of diabetic ketoacidosis.

Choice B Reason
Sodium at 135 mg/dL and Potassium at 3.5 mEq/L are within normal ranges. The normal range for serum sodium is approximately 135-145 mEq/L, and for serum potassium, it is around 3.5-5.0 mEq/L. These values do not indicate an immediate concern for the patient with urosepsis.

Choice C Reason
A BUN of 34 mg/dL and Creatinine of 4.2 mg/dL are concerning. The normal range for BUN is approximately 6-20 mg/dL, and for Creatinine, it is about 0.6-1.2 mg/dL for males and 0.5-1.1 mg/dL for females. Elevated levels of BUN and Creatinine indicate impaired kidney function, which can be a complication of urosepsis and the nephrotoxic effects of gentamicin and vancomycin.

Choice D Reason
A white blood cell count of 12,000/mm³ is slightly elevated, which may be expected in a patient with an infection such as urosepsis. The normal range is approximately 4,500-11,000 WBCs/mm³. While this should be monitored, it does not require immediate reporting unless there is a significant change or it is outside the patient's baseline.

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Correct Answer is D

Explanation

Choice A reason:

Ulnar deviation, which is the angling of the fingers towards the little finger side of the hand, is more commonly associated with rheumatoid arthritis, not osteoarthritis. Osteoarthritis typically affects the joint's cartilage, leading to pain and stiffness, rather than causing the fingers to deviate.

Choice B reason:

Symmetric joint involvement is also more characteristic of rheumatoid arthritis. Osteoarthritis usually affects joints asymmetrically, meaning it's more likely to affect one side of the body or one particular joint at a time.

Choice C reason:

Weight loss is not a direct manifestation of osteoarthritis. In fact, being overweight is a risk factor for developing osteoarthritis due to the increased stress on weight-bearing joints. However, weight management through diet and exercise can be part of the treatment plan for osteoarthritis to alleviate symptoms and improve joint function.

Choice D reason:

Joint stiffness and limited range of motion are hallmark manifestations of osteoarthritis. These symptoms result from the breakdown of cartilage within the joints, which leads to pain and difficulty moving the affected joint. Stiffness is often most noticeable upon waking or after periods of inactivity, and the range of motion may decrease as the condition progresses.

A. Provide a quiet atmosphere for undisturbed sleep. B. Cluster activities in the morning when well-rested. C. Identify ways to conserve energy when performing activities. D. Recommend small frequent iron-rich meals.

Correct Answer is C

Explanation

Choice A Reason
Providing a quiet atmosphere for undisturbed sleep is beneficial for all patients, especially those recovering from illness. However, it does not directly address the issue of activity intolerance. Adequate rest is important, but the primary concern with activity intolerance is managing energy levels during waking hours to improve the patient's ability to engage in activities.

Choice B Reason
Clustering activities in the morning may seem like a good strategy when the patient is well-rested. However, this could lead to rapid depletion of energy reserves and exacerbate activity intolerance. It is more effective to spread activities throughout the day to manage energy levels better.

Choice C Reason
Identifying ways to conserve energy is a key intervention for managing activity intolerance. This can include teaching the patient energy-conservation techniques, such as sitting while showering or dressing, taking frequent breaks, and prioritizing tasks. This approach helps patients with folic acid deficiency anemia to participate in activities without excessive fatigue.

Choice D Reason
While nutrition is important in the management of anemia, recommending small frequent iron-rich meals does not directly address activity intolerance. Folic acid deficiency anemia requires dietary intake of folate-rich foods or supplements. Iron is important, but the focus for folic acid deficiency should be on folate.

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A client is receiving gentamicin and vancomycin IV for urosepsis. Which diagnostic study result should the nurse report to the primary care practitioner?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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