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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason
Hyperreflexia refers to an overactive or overresponsive reflexes, which is a neurological condition and not directly related to the behaviors described. It is typically seen in conditions affecting the central nervous system and is not characterized by the inability to wait turns or interrupting conversations.
Choice B Reason
Defiance implies a conscious choice to resist authority or rules, which may not necessarily be the case here. While children with behavioral issues may exhibit defiant behaviors, the symptoms described are more indicative of a lack of impulse control rather than a deliberate choice to defy.
Choice C Reason
Inattention is a component of several behavioral and cognitive disorders, including ADHD. However, the behaviors described—blurting out answers, inability to wait for turns, and interrupting others—are more specifically associated with impulsivity rather than inattention alone.
Choice D Reason
Impulsivity is the tendency to act on a whim, displaying behavior characterized by little or no forethought, reflection, or consideration of the consequences. The behaviors described—such as blurting out answers and interrupting others—are classic signs of impulsivity, which is often seen in conditions like ADHD.
Correct Answer is D
Explanation
Choice A Reason:
Avoiding frustration by performing activities of daily living (ADLs) for the client may seem helpful, but it can actually lead to increased dependency and a faster decline in the ability to perform these tasks. It is important to encourage independence as much as possible.
Choice B Reason:
Telling jokes or riddles and discussing new items might provide temporary entertainment but does not necessarily help a client with dementia function better in their environment. It could also potentially cause confusion or frustration if the client does not understand or remember the context.
Choice C Reason:
Bringing new topics and options to the client's attention can be overwhelming and may contribute to confusion. Clients with dementia benefit from consistency and routine, which helps them feel more secure and oriented.
Choice D Reason:
Assisting the client to perform simple tasks by giving step-by-step directions is a beneficial intervention. It supports the client's ability to maintain independence and function within their environment for as long as possible. This approach aligns with the goal of maximizing the client's abilities and fostering a sense of accomplishment.
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