The nurse is reviewing the prescriptions for a client with severe pain from renal colic.
Which of the following prescriptions should the nurse implement first?

Choice A rationale

Teaching preventive measures is important for reducing recurrence of urinary tract infections (UTIs). These measures may include proper hydration, perineal hygiene, and urinating after intercourse. However, addressing preventive strategies is a long-term consideration and not the immediate priority for managing the active infection or preventing acute complications.

Choice B rationale

Preventing progression to complications is the priority in lower UTIs to avoid upper urinary tract involvement, such as pyelonephritis. This involves timely antibiotic administration and monitoring for signs like fever, flank pain, or worsening urinary symptoms. Pyelonephritis can lead to systemic complications like sepsis, making prevention critical to client safety.

Choice C rationale

Educating about treatment, such as the prescribed antibiotics and their potential side effects, ensures adherence and understanding. While valuable, it does not take precedence over immediate measures to halt disease progression or complications. Education supports long-term management but follows urgent clinical priorities.

Choice D rationale

Pain management is essential for comfort, addressing dysuria or pelvic pain associated with UTIs. Methods include analgesics like phenazopyridine. However, it is a supportive measure rather than a critical intervention for preventing complications, making it secondary to stopping the progression of the infection.

Choice A rationale

Asking about medication use may provide helpful information but does not address the primary concern. The symptoms of visual changes and headaches can indicate serious conditions such as increased intracranial pressure or hypertensive crisis. Immediate assessment is necessary to determine severity and prevent complications. Identifying a potential trigger does not replace the need for prompt diagnostic evaluation.

Choice B rationale

Referring the client to an eye specialist might be appropriate in cases of persistent vision issues without urgent symptoms. However, when combined with headaches, these symptoms could indicate systemic or neurological issues, such as hypertension or a brain lesion. Immediate action is required, as delayed assessment might allow for worsening of an acute condition.

Choice C rationale

Obtaining a full history and physical would provide valuable data for diagnosis. However, this approach is time-intensive and may not address the urgency of the situation. Rapid assessment, such as blood pressure measurement, takes precedence to identify conditions that could be immediately life-threatening, such as hypertensive emergencies.

Choice D rationale

Measuring blood pressure promptly assesses for hypertensive crises, a common cause of vision changes and headaches. Hypertensive crises require immediate treatment to prevent end-organ damage. Normal blood pressure ranges are typically 120/80 mmHg, and values exceeding 180/120 mmHg indicate a crisis. This action provides quick, actionable information critical for patient safety.