A nurse is caring for an adult client who has a fever of 39.4°C (103°F) and is receiving 0.9% sodium chloride IV at 125 mL/hr. Over the last hour, the nurse notes that the client's urine output is 20 mL. The nurse should report this finding to the provider and anticipate a prescription for what?
An antipyretic medication
A diuretic medication
A blood culture
A fluid bolus
The Correct Answer is D
Choice A reason: An antipyretic medication is not the best answer because it does not address the client's low urine output. An antipyretic medication is a drug that lowers the body temperature by reducing the production of heat or increasing the loss of heat. It may help the client feel more comfortable, but it does not improve the kidney function or prevent dehydration.
Choice B reason: A diuretic medication is not the best answer because it may worsen the client's low urine output. A diuretic medication is a drug that increases the excretion of water and electrolytes by the kidneys. It may lower the blood pressure and reduce the fluid overload, but it may also cause dehydration, electrolyte imbalance, and kidney damage.
Choice C reason: A blood culture is not the best answer because it does not address the client's low urine output. A blood culture is a laboratory test that detects the presence of bacteria or other microorganisms in the blood. It may help identify the cause of the fever and guide the antibiotic therapy, but it does not improve the kidney function or prevent dehydration.
Choice D reason: A fluid bolus is the best answer because it may improve the client's low urine output. A fluid bolus is a rapid infusion of a large volume of fluid, usually isotonic saline or lactated Ringer's solution. It may increase the blood volume and pressure, improve the tissue perfusion, and stimulate the urine production. It may also help lower the fever by diluting the pyrogens and increasing the heat loss.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Constipation is not a priority finding for a client with peptic ulcer disease. It may be a side effect of some medications or a result of decreased fluid intake, but it does not indicate a serious complication.
Choice B reason: Dyspepsia is a common symptom of peptic ulcer disease, but it is not a priority finding. It refers to indigestion or discomfort in the upper abdomen, which may be relieved by antacids or other medications.
Choice C reason: Hematemesis is a priority finding for a client with peptic ulcer disease. It indicates bleeding from the ulcer, which can lead to shock and anemia. The nurse should monitor the client's vital signs, hemoglobin level, and blood loss, and notify the provider immediately.
Choice D reason: Epigastric discomfort is another common symptom of peptic ulcer disease, but it is not a priority finding. It refers to pain or burning in the upper abdomen, which may be worsened by food intake or stress. The nurse should provide comfort measures and educate the client on dietary and lifestyle modifications.
Correct Answer is B
Explanation
Choice A reason: This is not a correct answer because intracorporeal lithotripsy is a procedure that uses a laser or an ultrasonic probe to break up gallstones inside the gallbladder or the bile ducts. It is not a preferred treatment for cholecystitis, as it does not remove the inflamed gallbladder.
Choice B reason: This is a correct answer because laparoscopic cholecystectomy is a surgery that removes the gallbladder through small incisions in the abdomen. It is the preferred treatment for cholecystitis, as it eliminates the source of inflammation and prevents further complications.
Choice C reason: This is not a correct answer because extracorporeal shock wave lithotripsy (ESWL) is a procedure that uses shock waves to break up gallstones outside the body. It is not a preferred treatment for cholecystitis, as it does not remove the inflamed gallbladder and may not be effective for all types of gallstones.
Choice D reason: This is not a correct answer because methyl tertiary butyl ether (MTBE) infusion is a procedure that uses a chemical solvent to dissolve gallstones inside the gallbladder. It is not a preferred treatment for cholecystitis, as it does not remove the inflamed gallbladder and may cause side effects such as nausea, vomiting, and liver damage.
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