The nurse is caring for an 84-year-old female client who was brought to the emergency room by her daughter, who related that her mother has had very recent mental status changes and periods of incontinence. What condition should the nurse first suspect?

A. Urinary tract infection
The symptoms described, including recent mental status changes and periods of incontinence, are suggestive of a urinary tract infection (UTI) in an elderly individual. UTIs are common among older adults and can cause a variety of symptoms, including confusion, which is often the primary manifestation in the elderly population. Other symptoms can include urinary urgency, frequency, and incontinence.

B. Acute kidney failure - While acute kidney failure can cause changes in urination and mental status, it is less likely to be the primary cause of these symptoms in this scenario. UTI is a more common and immediate concern given the symptoms described.

C. Septic shock - Septic shock is a severe condition that occurs when an infection leads to a life-threatening drop in blood pressure. While septic shock can cause altered mental status, it is a critical condition that often presents with more dramatic symptoms and requires immediate intensive care management. The symptoms described are more suggestive of a UTI.

D. Urinary stasis - Urinary stasis refers to the slowing or cessation of urine flow. While urinary stasis can contribute to the development of UTIs, it is not a condition that would cause sudden and acute mental status changes and incontinence on its own. UTI is a more likely cause of the symptoms described.

A. Apply cold compress to the client's flank area - Applying a warm compress, not a cold one, to the flank area can help alleviate pain associated with urolithiasis. Heat can promote muscle relaxation and increase blood flow to the area, potentially easing discomfort.

B. Restrict protein intake to 2 servings per day - There is no direct connection between protein intake and urolithiasis. However, specific dietary recommendations may vary based on the type of kidney stones a person has. For example, individuals with certain types of stones might be advised to limit oxalate-rich foods. It's essential to tailor dietary advice based on the composition of the stones.

C. Encourage intake of at least 3 L of fluids per day - Adequate fluid intake, particularly water, is crucial for preventing the formation of kidney stones. Increased fluid intake can help dilute substances in the urine that contribute to stone formation, reducing the risk of stone recurrence.

D. Discourage ambulation - Encouraging ambulation and movement is generally beneficial for patients with urolithiasis. Movement can help alleviate discomfort, prevent complications such as blood clots, and promote overall well-being. Restricting movement unnecessarily is not advisable.