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While increasing fluid intake is generally recommended for a urinary tract infection to help flush bacteria from the urinary system, tomato juice is typically alkaline. An alkaline environment can promote bacterial growth. Cranberry juice, which makes the urine more acidic and inhibits bacterial adhesion to the bladder wall, would be a more beneficial instruction than tomato juice.

The instruction to wipe back to front after voiding is incorrect. The proper technique is to wipe front to back (urethra to anus). This prevents the transfer of E. coli bacteria, which are naturally found in the gastrointestinal tract, from the anal area into the relatively clean urethra, thus significantly reducing the risk of developing a urinary tract infection.

Antibiotics should be taken for the entire prescribed duration, even if symptoms such as dysuria (painful urination) resolve quickly. Stopping antibiotics prematurely can lead to a recurrence of the infection and contributes to the development of antibiotic-resistant strains of bacteria, which are much harder to treat effectively in the future. —.

Hypothermia, which is a body temperature below 35 degrees C (95 degrees F), is not a typical finding with simple diarrhea. Diarrhea, especially if caused by an infectious agent, is more likely to cause a slight fever or a normal temperature as the body mounts an immune response. Severe dehydration may cause slight fluctuations, but not reliably hypothermia.

Decreased or hypoactive bowel sounds indicate reduced intestinal motility, which is commonly associated with an obstruction, paralytic ileus, or constipation. Diarrhea, conversely, is characterized by increased, hyperactive bowel sounds as a result of the rapid movement of intestinal contents through the gastrointestinal tract due to increased peristalsis.

A rigid abdomen is a critical sign of peritoneal inflammation or irritation, often indicating a serious acute condition like peritonitis, appendicitis, or a perforated viscus, which may or may not be the direct cause of the diarrhea. Simple diarrhea typically does not cause a rigid abdomen; the abdomen is usually soft and potentially distended or tender. —.

Jugular vein distension (JVD) is a cardinal sign of increased pressure in the systemic venous circulation, indicating right-sided heart failure. When the right ventricle fails, blood backs up into the right atrium and then into the great veins, causing distension and visibility of the internal and external jugular veins in the neck.

Dependent edema, which is swelling in the lower extremities, is a typical manifestation of right-sided heart failure. The inability of the right ventricle to manage systemic venous return causes blood to pool in the peripheral veins, leading to increased hydrostatic pressure that forces fluid out of the capillaries into the interstitial tissue.

Nocturnal polyuria, or increased urination at night, is a common symptom in heart failure but is more directly related to the movement of pooled dependent edema fluid (from the legs/feet) back into the central circulation when the client lies down. This increases renal blood flow and diuresis, but is not exclusively an assessment finding for left-sided failure.

The left atrium receives oxygenated blood from the lungs via the pulmonary veins and then pumps it into the left ventricle. This chamber is part of the systemic circulation loop, receiving the final product of pulmonary circulation, and is not the starting point for the flow of blood from the heart to the lungs.

The pulmonary artery is the vessel that transports deoxygenated blood from the right ventricle to the lungs. While it carries the blood to the lungs, it is the vessel following the starting chamber, which is the right ventricle, the contracting muscle that generates the initial pressure for the blood's journey.

The pulmonary veins carry oxygenated blood from the lungs back to the left atrium of the heart. These vessels are the termination point of the pulmonary circulation loop, after gas exchange has occurred in the capillaries of the lungs, and therefore they are not involved in the initial outflow to the lungs. —.

Reflex incontinence involves the involuntary loss of urine that occurs at somewhat predictable intervals when the bladder volume reaches a specific level. This type is typically associated with spinal cord damage or neurological impairment above the sacral reflex arc, which causes the detrusor muscle to contract reflexively without the client's sensation of needing to void.

Urge incontinence is characterized by the sudden, strong urge to void immediately preceding an involuntary loss of urine. It is typically caused by bladder instability or overactivity of the detrusor muscle, often termed an overactive bladder. The client with urge incontinence generally does not have associated urinary retention or chronic bladder distension.

Stress incontinence involves the involuntary leakage of small amounts of urine that occurs with increased intra-abdominal pressure, such as coughing, sneezing, laughing, or physical exertion. This is usually due to weakened pelvic floor muscles and/or a deficient urethral sphincter mechanism, which cannot withstand the momentary pressure increase. —.

While a pregnancy test is important in a sexually active woman presenting with urinary symptoms to rule out ectopic pregnancy or potential teratogenic antibiotic exposure, the initial step must be to gather comprehensive data. A pregnancy test is a diagnostic tool, and its necessity follows the initial data collection for context.

A urine culture is a specific diagnostic test used to identify the causative organism in a suspected urinary tract infection. Although a urine sample collection will likely follow the initial assessment, ordering the culture before a thorough history and physical is premature and does not follow the standard, systematic approach to patient care.

Starting empiric antibiotics without a thorough assessment and potential diagnostic confirmation is poor medical practice. Although the symptoms strongly suggest a urinary tract infection, a course of antibiotics should only be initiated after a history and physical and, ideally, after obtaining a urine sample for testing to ensure appropriate, targeted therapy. —.

Liver failure, while causing numerous systemic effects, primarily affects clotting factors, drug metabolism, and albumin synthesis. It does not directly cause an increased risk of acute urinary retention through a known physiological mechanism; the risk of acute kidney injury from hepatorenal syndrome is an entirely separate and distinct complication.

A diet high in calcium oxalate is a risk factor for the formation of calcium oxalate kidney stones (nephrolithiasis). While kidney stones can potentially cause obstruction leading to post-renal acute kidney injury or urinary retention, the diet itself is not the primary direct risk factor for retention compared to immediate post-operative effects.

Glomerulonephritis is an inflammatory disease of the kidney glomeruli, often following an infection like streptococcal pharyngitis (not staphylococcal). This primarily leads to hematuria, proteinuria, and decreased glomerular filtration rate, not specifically an increased risk for acute urinary retention, which is a lower urinary tract issue. —.

A red, beefy tongue, or glossitis, is primarily a sign of a severe deficiency in B vitamins, such as B12, folate, or niacin, which is associated with conditions like pernicious anemia. This is not a characteristic sign or symptom of toxicity resulting from the cardiac glycoside medication digoxin, which exerts its effects on the heart muscle and central nervous system.

Digoxin toxicity commonly manifests with early gastrointestinal symptoms, but these typically include nausea, vomiting, anorexia, and sometimes diarrhea, which reflect central nervous system stimulation. Constipation, which is the decreased frequency of bowel movements, is not a common or expected side effect or sign of drug toxicity.

Weight gain, especially rapid gain, can indicate fluid retention due to worsening heart failure, a condition digoxin is used to treat. While toxicity can cause anorexia (loss of appetite), it does not typically cause weight gain. Therefore, weight gain may suggest therapeutic failure or worsening disease, not necessarily digoxin toxicity itself. —.