A nurse is assisting with the care of a client.

Exhibits

For each data collection finding, dick to specify if the finding is consistent with ulcerative colitis, diverticulitis, or Crohn's disease. Each finding may support more than 1 disease process.

A chest x-ray is an essential diagnostic tool for evaluating a client with symptoms such as a productive cough, blood-tinged sputum, weight loss, night sweats, and a low-grade fever. These findings raise suspicion for tuberculosis (TB), particularly given the client’s recent travel to South Africa, where TB is more prevalent. A chest x-ray can help identify characteristic abnormalities such as upper lobe infiltrates, cavitations, or pleural effusions that are consistent with pulmonary TB.

A nasopharyngeal swab is primarily used to detect viral respiratory infections, such as influenza or COVID-19. While the client presents with a cough and fever, the chronic nature of symptoms and presence of hemoptysis make a viral infection less likely. Furthermore, viral infections typically present with acute onset symptoms rather than a prolonged illness with weight loss and night sweats.

Blood cultures are used to identify systemic bacterial infections, such as bacteremia or sepsis. Although the client has a fever, there are no indications of severe systemic infection, such as hypotension or signs of shock, making blood cultures a lower priority in this case.

A pulmonary function test evaluates lung function in conditions such as asthma or chronic obstructive pulmonary disease (COPD). The client has no history of these conditions, and their primary complaint involves symptoms suggestive of an infectious process rather than an obstructive pulmonary disease. Pulmonary function testing is not indicated for diagnosing TB or other respiratory infections.

A Mantoux test (tuberculin skin test) is a key diagnostic tool in assessing tuberculosis exposure. Given the client’s symptoms and travel history, this test helps determine prior exposure to Mycobacterium tuberculosis and the likelihood of latent or active infection. A positive test would support further diagnostic testing, such as sputum cultures, to confirm active TB disease.

• Calcium level: Decreased due to furosemide, a loop diuretic that increases calcium excretion in the urine, leading to mild hypocalcemia.
• Potassium level: Decreased due to furosemide, which causes potassium loss through diuresis. Lisinopril, an ACE inhibitor, can cause potassium retention, but in this case, the effect of furosemide dominates.
• Sodium level: Decreased due to furosemide-induced diuresis, which can lead to hyponatremia by excessive sodium loss.
• Edema: Improved due to furosemide, which promotes fluid removal and reduces volume overload associated with heart failure.
• Oxygen saturation: Improved due to carvedilol, which reduces heart failure symptoms by decreasing myocardial oxygen demand and improving cardiac output.
• Blood pressure: Lowered due to both carvedilol (a beta-blocker) and lisinopril (an ACE inhibitor), both of which reduce systemic vascular resistance.
• Weight: Decreased due to both carvedilol, which helps manage fluid retention over time in heart failure, and furosemide, which directly reduces fluid overload through diuresis.