A nurse in an assisted living facility is collecting data from an older adult client who fell in their room and hit their head on the dresser. Which of the following findings is the nurse's priority?

Choice A Reason:
Peripheral edema is typically associated with conditions that cause fluid retention or circulatory issues, such as heart failure, kidney disease, or chronic venous insufficiency. While it can occur in a variety of systemic conditions, it is not a hallmark finding specifically associated with peritonitis.

Choice B Reason:
Polyuria, which is an increase in urine volume, is more commonly associated with conditions affecting the kidneys, such as diabetes or diuretic use. It is not a characteristic finding in peritonitis, which primarily affects the abdominal cavity.

Choice C Reason:
Absent bowel sounds are a significant finding in peritonitis. The inflammation of the peritoneum often leads to a paralytic ileus, where the bowel stops functioning properly. This can result in an absence of the normal gurgling sounds made by the intestines, which is a critical sign that healthcare providers look for when assessing for peritonitis.

Choice D Reason:
Decreased respirations may occur in peritonitis due to the pain and discomfort associated with the inflammation of the abdominal cavity, which can inhibit deep breathing. However, this is not as specific or diagnostic as absent bowel sounds. Respiratory rate changes can be influenced by a variety of factors, including pain, medications, and systemic infections.

Choice A reason:
A white blood cell (WBC) count of 9,000/mm³ falls within the normal range of 5,000 to 10,000/mm³ and does not necessarily indicate a bladder infection. The WBC count can be elevated in infections, but a value within the normal range, especially without other symptoms, is not a reliable indicator of a urinary tract infection (UTI).

Choice B reason:
Diminished reflexes are not typically associated with a bladder infection. They can be a sign of neurological issues or other systemic conditions. Reflex changes would more likely prompt an evaluation for neurological disorders rather than a UTI.

Choice C reason:
Changed mental status in older adults can be a sign of a bladder infection. Unlike younger individuals, older adults may not exhibit the classic symptoms of a UTI, such as pain or burning during urination. Instead, they may present with non-specific symptoms like acute confusion or altered mental status, which can be a result of the infection's systemic impact.

Choice D reason:
A temperature of 37.3°C (99.1°F) is slightly elevated but is not considered a fever and could be influenced by various factors. While it could be associated with an infection, it is not a definitive sign of a bladder infection without the presence of other symptoms.