A nurse is reviewing urinary laboratory results. Which finding will cause the nurse to follow up?

Urine output of 80 mL/hr

Specific gravity of 1.036

pH of 6.4

Protein level of 2 mg/100 mL

Answer and Explanation

The Correct Answer is B

A. Urine output of 80 mL/hr: Normal urine output is 30–50 mL/hr. A urine output of 80 mL/hr is within an acceptable range and does not indicate a problem.

B. Specific gravity of 1.036: Normal urine specific gravity ranges from 1.005 to 1.030. A level of 1.036 indicates dehydration or concentrated urine, which requires further assessment.

C. pH of 6.4: Normal urine pH ranges from 4.5 to 8.0, with an average around 6.0. A pH of 6.4 is within normal limits and does not require follow-up.

D. Protein level of 2 mg/100 mL: Normal urine protein is less than 8 mg/100 mL, so 2 mg/100 mL is within normal limits and does not indicate a concern.

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Correct Answer is D

Explanation

A. After the client feels abdominal cramping: Too late. Cramping may indicate constipation or excessive straining.

B. Immediately before the client has a meal: Not effective. The gastrocolic reflex occurs after eating, not before.

C. Every 2 hr while the client is awake: This is unnecessary and does not align with the body’s natural elimination pattern.

D. When the client has the urge to defecate: Most effective approach. Encourages natural elimination patterns.

A. The patient is lonely and calling then nurse in under false pretenses is a way to get attention. B. The patient does not recognize the physiological signals that indicate a need to void. C. The patient is not drinking enough fluids to produce adequate urine output. D. The patient can be anxious, making it difficult for abdominal and perineal muscles to relax enough to void.

Correct Answer is D

Explanation

A. The patient is lonely and calling the nurse under false pretenses. This is an inappropriate assumption. The patient may be experiencing urinary hesitancy due to anxiety, not seeking attention.

B. The patient does not recognize the physiological signals that indicate a need to void. The patient recognized the need to void but is having difficulty due to psychological factors (e.g., anxiety, privacy concerns).

C. The patient is not drinking enough fluids to produce adequate urine output. The patient felt the urge to void, meaning they do have urine in the bladder. The issue is likely related to difficulty initiating urination rather than fluid intake.

D. The patient can be anxious, making it difficult for abdominal and perineal muscles to relax enough to void. Paruresis ("shy bladder syndrome") can make it difficult to void in the presence of others due to anxiety or embarrassment.

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A nurse is reviewing urinary laboratory results. Which finding will cause the nurse to follow up?

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