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The nurse is reviewing the laboratory results of an older adult client who has a urinary tract infection (UTI).

Which of the following findings should alert the nurse to a possible complication of UTI in older adults?

(Select all that apply.).

Elevated white blood cell count.

Decreased serum creatinine level.

Increased urine specific gravity.

Altered mental status.

Positive urine culture.

Answer and Explanation

Correct Answer : A,D,E

The correct answer is A, D, and E.

Here is why:.

A. Elevated white blood cell count.

This is a sign of infection and inflammation in the body, which can be caused by a UTI. An elevated white blood cell count can also indicate a complication of UTI such as pyelonephritis (kidney infection) or sepsis (blood infection) .

D. Altered mental status.

This is a common symptom of UTI in older adults, especially those with dementia or other cognitive impairments. UTIs can cause confusion, agitation, delirium, or behavioral changes in the elderly due to the effects of infection and inflammation on the brain .

E. Positive urine culture.

This is the definitive test to diagnose a UTI, as it identifies the type and number of bacteria present in the urine. A positive urine culture confirms the presence of a UTI and guides the appropriate antimicrobial treatment .

The other choices are wrong because:.

•.

B. Decreased serum creatinine level.

This is not a sign of UTI or its complications.

Serum creatinine is a measure of kidney function, and it usually increases when the kidneys are damaged or impaired. A decreased serum creatinine level may indicate other conditions such as liver disease, muscle wasting, or malnutrition .

•.

C. Increased urine specific gravity.

This is not a sign of UTI or its complications.

Urine specific gravity is a measure of urine concentration, and it usually increases when the body is dehydrated or has high levels of solutes in the urine. An increased urine specific gravity may indicate other conditions such as diabetes mellitus, heart failure, or dehydration .

Normal ranges for some of these tests are:.

• White blood cell count: 4,000 to 11,000 cells per microliter (mcL) of blood .

• Serum creatinine: 0.6 to 1.2 milligrams per deciliter (mg/dL) for men and 0.5 to 1.1 mg/dL for women .

• Urine specific gravity: 1.005 to 1.030 .

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Free Nursing Study Resources

Correct Answer is B

Explanation

The correct answer is B.

Diphenhydramine.Diphenhydramine is an antihistamine and sedative medication that can causedeliriumin older adults, especially when used in high doses or for a long time.Delirium is a serious change in mental abilities that results in confused thinking and reduced awareness of the surroundings.It can be caused by various factors, such as infections, medications, surgery, or alcohol or drug use or withdrawal.Delirium can have serious consequences, such as increased risk of falls, complications, and death.

Choice A is wrong because acetaminophen is a pain reliever and fever reducer that does not usually cause delirium in older adults.

However, acetaminophen overdose can cause liver damage and altered mental status.

Choice C is wrong because metformin is an oral medication that lowers blood sugar levels in people with type 2 diabetes.

Metformin does not typically cause delirium in older adults.

However, metformin can cause a rare but serious condition called lactic acidosis, which can cause confusion and other symptoms.

Choice D is wrong because lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that lowers blood pressure and prevents heart failure.

Lisinopril does not usually cause delirium in older adults.

However, lisinopril can cause a rare but serious condition called angioedema, which can cause swelling of the face, tongue, or throat and difficulty breathing.

Normal ranges for some relevant laboratory tests are:.

• Albumin: 3.5-5.0 g/dL.

• Potassium: 3.5-5.0 mEq/L.

• Total cholesterol: <200 mg/dL.

• Hemoglobin: 13.5-17.5 g/dL for men; 12.0-15.5 g/dL for women.

A. Decreased immune system function with aging. B. Lack of knowledge or awareness about STIs. C. Reduced use of condoms or other barrier methods. D. Increased number of sexual partners or casual encounters. E. Increased vaginal dryness or atrophy with menopause.

Correct Answer is ["A","B","C","D"]

Explanation

The correct answer isA, B, C and D.

These are all factors that can increase the risk of sexually transmitted infections (STIs) in older adult clients.

A. Decreased immune system function with aging.This can make older adults more susceptible to infections and less able to fight them off.

B. Lack of knowledge or awareness about STIs.

Older adults may not have received adequate education or information about STIs, their symptoms, prevention and treatment.They may also have misconceptions or stigma about STIs that prevent them from seeking help or testing.

C. Reduced use of condoms or other barrier methods.

Older adults may not perceive themselves as at risk of STIs or may not know how to use condoms correctly or consistently.They may also face barriers such as cost, availability, embarrassment or partner resistance to using condoms.

D. Increased number of sexual partners or casual encounters.

Older adults may have more opportunities for sexual activity due to factors such as divorce, widowhood, online dating, travel or retirement.They may also engage in sexual behaviors that expose them to multiple or unknown partners, such as sex work, drug use or group sex.

Choice E is wrong becauseincreased vaginal dryness or atrophy with menopauseis not a risk factor for STIs in older adult clients.

While this condition can cause discomfort, pain or bleeding during sexual intercourse, it does not increase the likelihood of acquiring or transmitting an STI.However, it may affect the quality of life and sexual satisfaction of older women and their partners, and may require medical attention or lubrication products.

: Johnson BK.

Sexually transmitted infections and older adults.J Gerontol Nurs 2013;39(11):53-60.: World Health Organization (WHO).

Sexually transmitted infections (STIs).2022 Aug 22.: Journal of Gerontological Nursing (JGN).

Sexually Transmitted Infections and Older Adults.

2013 Sep 18.

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The nurse is reviewing the laboratory results of an older adult client who has a urinary tract infection (UTI). Which of the following findings should alert the nurse to a possible complication of UTI in older adults? (Select all that apply.).

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medication list of an older adult client who has delirium. Which of the following medications can contribute to delirium in older adults?

Correct Answer is B

Explanation

A nurse is assessing the risk factors for sexually transmitted infections (STIs) in older adult clients. Which of the following factors should the nurse consider? (Select all that apply.).

Correct Answer is ["A","B","C","D"]

Explanation

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The nurse is reviewing the laboratory results of an older adult client who has a urinary tract infection (UTI).

Which of the following findings should alert the nurse to a possible complication of UTI in older adults?

(Select all that apply.).