A nurse is planning care for a client who has pyelonephritis. Which of the following interventions should the nurse include in the plan?

Provide instruction on pelvic muscle exercises.

Administer skeletal muscle relaxants every 6 hr.

Encourage fluid intake.

Monitor vital signs every 8 hr.

Answer and Explanation

The Correct Answer is C

A) Provide instruction on pelvic muscle exercises:
Pelvic muscle exercises are beneficial for urinary incontinence but are not a standard intervention for treating pyelonephritis. Pyelonephritis focuses on managing infection and inflammation of the kidneys rather than strengthening pelvic muscles.

B) Administer skeletal muscle relaxants every 6 hr:
Skeletal muscle relaxants are not typically used in the treatment of pyelonephritis. The focus should be on antibiotics to treat the infection and analgesics for pain relief, rather than muscle relaxants.

C) Encourage fluid intake:
Increasing fluid intake helps flush bacteria from the urinary tract, which can aid in reducing the infection and promoting kidney health. Proper hydration is crucial for clients with pyelonephritis to help manage symptoms and prevent further complications.

D) Monitor vital signs every 8 hr:
While monitoring vital signs is important, it should be done more frequently than every 8 hours, especially in the acute phase of pyelonephritis, to promptly identify any signs of worsening infection or sepsis.

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Correct Answer is C

Explanation

A) Cimetidine: Cimetidine is an H2 receptor antagonist used to reduce stomach acid and treat conditions such as peptic ulcers and gastroesophageal reflux disease (GERD). It is not used to manage metabolic acidosis.

B) Calcitonin: Calcitonin is used to regulate calcium levels and treat conditions like osteoporosis or hypercalcemia. It does not address metabolic acidosis and is not appropriate for this condition.

C) Sodium bicarbonate: Sodium bicarbonate is commonly used to treat metabolic acidosis. It works by neutralizing excess acid in the blood, thereby increasing the blood's pH and helping to correct the acid-base imbalance associated with metabolic acidosis.

D) Sodium chloride: Sodium chloride is a salt that can be used to manage fluid and electrolyte imbalances but does not correct metabolic acidosis. It is not suitable for treating the acid-base imbalance seen in metabolic acidosis.

A. Offer the client a small meal if she is not nauseated. B. Administer 1 mg of glucagon intramuscularly to the client. C. Contact the client's provider for further instructions D. Transport the client to an emergency department for treatment.

Correct Answer is B

Explanation

A) Offer the client a small meal if she is not nauseated:
While eating a small meal can help raise blood glucose levels, it is not the immediate priority in a severe hypoglycemia situation. The client might be unconscious or unable to swallow safely, making this action inappropriate as a first step.

B) Administer 1 mg of glucagon intramuscularly to the client:
Administering glucagon intramuscularly is the most crucial initial action. Glucagon rapidly increases blood glucose levels by stimulating glycogen breakdown in the liver. This is vital for quickly reversing severe hypoglycemia, especially if the client is unconscious or unable to ingest carbohydrates orally.

C) Contact the client's provider for further instructions:
Contacting the provider is essential, but it should occur after addressing the immediate hypoglycemic episode. Once the client's condition stabilizes, further guidance can be sought from the healthcare provider.

D) Transport the client to an emergency department for treatment:
Transporting the client to the emergency department is necessary if the hypoglycemia does not improve after administering glucagon or if the client remains unresponsive. However, it is not the first action; immediate glucagon administration takes precedence to stabilize the client's condition before considering transportation.

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