A nurse is providing safe sex education to a group of adolescents.Which of the following statements should the nurse include in the education? (Select all that apply.)

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.

Choice A rationale

Aspirin (acetylsalicylic acid) at a low daily dose of 81 mg is typically used for its antiplatelet effects (irreversible inhibition of COX-1 in platelets) to prevent cardiovascular events. This dose has minimal analgesic or anti-inflammatory effects. Therefore, monitoring a pain rating of 6 or more is not a primary concern for this specific prophylactic indication.

Choice B rationale

Encouraging increased intake of green leafy vegetables, which are rich in Vitamin K, is relevant for clients on warfarin (Coumadin), as Vitamin K can counteract its effect. Aspirin, however, works on platelet aggregation and is not affected by dietary Vitamin K levels. This advice is irrelevant to the pharmacodynamics of aspirin.

Choice C rationale

Aspirin is a non-steroidal anti-inflammatory drug (NSAID) that can cause gastrointestinal irritation and bleeding, a side effect that is dose-dependent but still possible with low-dose therapy. Black, tarry stools (melena) are an indication of upper gastrointestinal bleeding due to the degradation of hemoglobin to hematin. The nurse must monitor for this serious adverse effect.

Choice D rationale

Aspirin, especially at higher doses, can impair renal function by inhibiting prostaglandin synthesis, which is essential for maintaining renal blood flow. This effect typically leads to an increase (not a sudden drop) in blood urea nitrogen (BUN) (normal range 8-20 mg/dL) and creatinine (normal range 0.6-1.2 mg/dL) levels due to decreased glomerular filtration.