A nurse in a clinic is caring for a female client who has gonorrhea.
Which of the following actions should the nurse take?

Choice A rationale

Chlamydia trachomatis infection in males can cause urethritis, epididymitis, and proctitis, leading to pain and inflammation; however, it is not a common or direct cause of meningitis. Meningitis is typically caused by bacterial pathogens like Neisseria meningitidis or Streptococcus pneumoniae or viral agents that infect the meninges, the membranes covering the brain and spinal cord.

Choice B rationale

Persistent infection with high-risk types of Human Papillomavirus (HPV) is the primary cause of nearly all cases of cervical cancer due to the integration of viral DNA into host cells, leading to cellular transformation. The HPV oncoproteins E6 and E7 interfere with host tumor suppressor proteins, such as p and retinoblastoma protein, promoting uncontrolled cell proliferation and malignant progression in the cervical epithelium.

Choice C rationale

Pelvic Inflammatory Disease (PID) is an infection of the female reproductive organs, most commonly caused by ascending infection from the cervix with bacteria, particularly Neisseria gonorrhoeae and Chlamydia trachomatis. Herpes Simplex Virus (HSV) typically causes localized genital lesions or, less commonly, systemic symptoms, but it is not generally recognized as a significant causative agent for the upper tract infection that defines PID.

Choice D rationale

A neonate can acquire Chlamydia trachomatis during vaginal birth from an infected mother, leading to neonatal conjunctivitis (ophthalmia neonatorum), an infection of the mucous membrane lining the eyelids. If this infection is untreated, it can cause corneal scarring, potentially leading to visual impairment or blindness, underscoring the importance of prenatal screening and prophylactic eye treatment.

Choice A rationale

An elevated Hct (normal ≈ 36%-50%), elevated BUN (normal 8-20 mg/dL), and high urine specific gravity (normal 1.005-1.030) are all indicative of volume depletion or dehydration. Monitoring intake and output precisely quantifies the fluid balance, which is crucial for determining the degree of deficit and evaluating the effectiveness of rehydration therapy.

Choice B rationale

The client's confusion and weakness are potential symptoms of dehydration, as reduced intravascular volume can impair cerebral perfusion and electrolyte imbalances can disrupt nerve and muscle function. Regularly checking orientation provides an essential ongoing assessment of the client's neurological status and the effectiveness of fluid replacement.

Choice C rationale

The client's lab values and symptoms strongly suggest dehydration, which requires increased fluid intake, not restriction. Fluid restriction would exacerbate the existing hypovolemia, further worsening the elevated Hct, BUN, and specific gravity, potentially leading to renal compromise and worsening confusion.

Choice D rationale

Dehydration often leads to orthostatic hypotension due to reduced circulating blood volume. Instructing the client to sit briefly before standing allows time for baroreceptor reflexes to compensate for the positional change, preventing a sudden drop in blood pressure and minimizing the risk of a fall.

Choice E rationale

Daily weights provide a highly sensitive and objective measure of fluid status changes. A rapid change in body weight, especially in the context of dehydration and hypovolemia, directly reflects the magnitude of fluid loss or gain, making it a critical parameter for monitoring the effectiveness of interventions.