A patient has developed pitting edema in her lower legs and feet.
The nurse is knowledgeable about this condition. After the patient’s physician prescribes furosemide and the patient begins this new medication, what should the nurse anticipate?

Choice A rationale:

Brown or black urine is not a typical observation associated with Levodopa use. It can indicate other potential causes, such as: Dehydration

Liver disease

Rhabdomyolysis (muscle breakdown)

Certain medications like metronidazole or iron supplements

Hematuria (blood in the urine)

It's essential to rule out these conditions if brown or black urine is observed.

Choice C rationale:

Green or blue-green urine is also not common with Levodopa. It can be caused by:

Medications like amitriptyline, indomethacin, propofol, or methylene blue

Certain food dyes

Urinary tract infections caused by Pseudomonas bacteria

Familial benign hypercalcemia (a rare genetic condition)

Choice D rationale:

Blood-tinged urine (hematuria) is not a direct effect of Levodopa. It can signal underlying urinary tract issues, such as: Infections

Kidney stones

Bladder or kidney tumors

Trauma to the urinary tract

Strenuous exercise

Choice B rationale:

Orange or orange-red urine is the most common observation in patients taking Levodopa. This discoloration is due to: Breakdown of Levodopa into dopamine and other metabolites

These metabolites can impart an orange or reddish hue to the urine

The color intensity may vary depending on dosage and individual metabolism

It's generally harmless and doesn't require medical intervention

However, it's essential to inform healthcare providers about any urine color changes to ensure proper monitoring and rule out other potential causes.

Choice A rationale:
Anxiety is a valid concern for any client undergoing surgery, but it is not the priority nursing diagnosis in this case. The client's risk for infection is more pressing due to the following factors:
Large surgical wound: Wounds provide a potential entry point for pathogens.
Obesity: Excess adipose tissue can impair wound healing and increase the risk of infection.
Corticosteroid medications: These medications suppress the immune system, making it more difficult for the body to fight off infection.
Choice B rationale:
Self-care Deficit may be a concern if the client has difficulty caring for the surgical wound or maintaining hygiene due to obesity. However, it is not the priority diagnosis in this case. The focus should be on preventing infection, which would also help to address any self-care deficits.
Choice D rationale:
Risk for Imbalanced Nutrition is a relevant diagnosis for a client who has had colon surgery, as they may experience changes in appetite, digestion, or absorption of nutrients. However, it is not the priority diagnosis in this scenario. Preventing infection is crucial to ensure proper wound healing and overall recovery.
Choice C rationale:
Risk for Infection is the priority nursing diagnosis for this client due to the following risk factors: Large surgical wound: The wound provides a potential entry point for bacteria and other pathogens.
Obesity: Excess adipose tissue can impair wound healing by reducing blood flow to the area and increasing the risk of wound dehiscence (separation of wound edges). This can create a favorable environment for bacterial growth.
Corticosteroid medications: These medications suppress the immune system, making it more difficult for the body to fight off infection.
Nursing interventions to address Risk for Infection:
Assess the wound regularly for signs of infection, such as redness, swelling, warmth, pain, or purulent drainage. Implement strict aseptic technique when caring for the wound.
Teach the client about proper wound care and hygiene practices.
Monitor the client for signs of systemic infection, such as fever, chills, or malaise. Administer antibiotics as prescribed.
Encourage adequate nutrition and hydration to support wound healing.
Collaborate with the healthcare team to manage the client's risk factors for infection.