The nurse plans to collect a 24 hour urine specimen for a creatinine clearance test. Which instruction should the nurse provide to the adult male client?

Rationale:

• pH 7.40: A pH of 7.40 indicates that the client's acid-base balance is normal. This supports ventilation as the client’s respiratory system is effectively managing gas exchange.
• Blood pressure 112/77 mm Hg: This stable blood pressure is a sign that the client is adequately perfused, indicating management of hypovolemia. The blood pressure is now within a normal range, suggesting effective fluid resuscitation.
• PaCO2 42 mm Hg: The PaCO2 of 42 mm Hg is within normal limits, showing that the client's ventilation is adequate and confirming support of ventilation.
• Surgical dressing dry and intact: The intact dressing is important for preventing infection, as it ensures that there is no leakage or exposure to bacteria at the surgical site.
• Temperature 98.1° F (36.7° C): A temperature of 98.1° F (36.7° C is a normal and suggests successful rewarming or maintenance of normothermia, which contributes to Prevent infection as hypothermia can impair immune function and increase infection risk.
• Capillary refill 2 seconds: Capillary refill of 2 seconds is within normal limits and indicates good circulation and tissue perfusion, which is part of managing hypovolemia.
• Pain 0 on a scale of 0 to 10: The client’s report of no pain (pain score of 0) indicates that the goal of controlling pain and anxiety is being met, ensuring that the client is comfortable and stable.

Rationale for Correct Choices:

• Impaired physical mobility: Rheumatoid arthritis leads to joint inflammation, stiffness, and potential deformities. These symptoms may result in decreased range of motion and difficulty with physical movements, contributing to impaired mobility.
• Acute pain: RA causes acute inflammation in the joints, resulting in pain, especially during flare-ups. The client experiences pain and stiffness in the hands and wrists, which aligns with the acute pain risk associated with RA.
• Knowledge deficit: Newly diagnosed RA patients often lack understanding about the disease process, treatment options, and lifestyle modifications. The nurse needs to recognize that the client requires education to manage their condition effectively and understand the long-term implications.

Rationale for Incorrect Choices:

• Electrolyte imbalance: Electrolyte imbalances are not a typical complication of rheumatoid arthritis. While certain medications used to treat RA (like corticosteroids) can impact electrolyte levels, this is not an immediate concern or a direct risk associated with RA itself.